Pentoxifylline: Evidence strong enough for renoprotection?

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Pentoxifylline is a methylxanthine derivative and nonselective phosphodiesterase inhibitor that has been widely used for improving peripheral and cerebral vascular microcirculation.In addition to its hemorheologic activity, laboratory evidence has shown that pentoxifylline provides antiproliferative and anti-inflammatory effects that are organoprotective.Since Professor Tsai proposed in 1995 that pentoxifylline may have a potential to delay the progression of chronic glomerulopathy associated with mesangial proliferation, we have become one of the leading groups investigating the renoprotective effect of pentoxifylline in both experimental and clinical fields. 1 We demonstrated beneficial effects of pentoxifylline in attenuating proteinuria and glomerulosclerosis in different animal models of renal diseases, including rasts with anti-Thy1 nephritis, crescentic glomerulonephritis, and remnant kidney. 2 Mechanistically, we proved that pentoxifylline suppresses the increased expression of tumor necrosis factor a, intercellular adhesion molecule-1, monocyte chemoattractant protein-1, and osteopontin.In addition to antiproliferative effect, these anti-inflammatory actions are associated with reduction of proteinuria and attenuation of glomerular crescents, sclerosis, and interstitial fibrosis.Moreover, we recently demonstrated that pentoxifylline Conflicts of interest: The authors have no conflicts of interest relevant to this article.