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Review
. 2025 May 20:16:1513329.
doi: 10.3389/fphar.2025.1513329. eCollection 2025.

Traditional Chinese Medicine targeting the TGF-β/Smad signaling pathway as a potential therapeutic strategy for renal fibrosis

Hao Jiao  1   2 , Meijuan Zhang  3 , Lili Chen  4 , Zhirui Zhang  1   2
Affiliations
Review

Traditional Chinese Medicine targeting the TGF-β/Smad signaling pathway as a potential therapeutic strategy for renal fibrosis

Hao Jiao et al. Front Pharmacol. .

Abstract

Renal fibrosis (RF) is an inevitable outcome of nearly all progressive chronic kidney diseases (CKD). However, effective therapies that can halt or reverse the development of RF and CKD progression remain limited. Traditional Chinese Medicine (TCM) offers a unique therapeutic approach, demonstrating significant anti-fibrotic potential through its antioxidant and anti-inflammatory pharmacological properties. However, comprehensive reviews focusing on the role of TCM in targeting signaling pathways associated with RF are still scarce. In this review, the literature was screened according to the clarity of the relevance of TCM, including the types and mechanisms of TCM. We summarize the pivotal role of the TGF-β/Smad signaling pathway in RF and provide an overview of single Chinese botanical drug, their active ingredients, and TCM compounds that ameliorate RF by modulating this pathway, aiming to establish a solid foundation for future basic and clinical research in the field of RF. While TCM holds unique advantages in treating RF, its limitations need to be addressed through scientific research and technological innovation. Future studies will focus on elucidating mechanisms, improving quality control, validating clinical efficacy, and fostering international collaboration to promote the scientific and global application of TCM in modern medicine.

Keywords: Chinese herbal compounds; TGF-β/Smad signaling pathway; Traditional Chinese Medicine; renal fibrosis; therapeutic strategy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Pathological mechanism of RF (Zhou et al., 2022).
FIGURE 2
FIGURE 2
Regulatory functions of the TGF-β/Smad signaling pathway in the renal fibrosis. ECM deposition is the most important pathological change of renal fibrosis. TGF-β and extracellular matrix are the main factors affecting ECM. TGF-β can indirectly lead to ECM by inducing epigenetic modification and miRNA expression directly in the synthetic fiber matrix through the TGF-β/Smad signaling pathway, or by inducing the accumulation of myofibroblasts by inducing cell phenotypic transformation. The abnormal expression of metalloproteinases and CTGF in extracellular matrix is also an important reason for aggravating RF.
FIGURE 3
FIGURE 3
Therapeutic targets in TGF-β/Smad signaling in renal fibrosis.
See this image and copyright information in PMC

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