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Peer-reviewedCC BY 4.0Frontiers in Immunology

Epigenetic and mitochondrial regulation in kidney disease: emerging mechanisms and therapeutic opportunities

  1. 1Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
  2. 2Department of Pharmacology, Faculty of Pharmacy, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, Mandya, India

Abstract

Renal fibrosis is an important pathogenic characteristic in the course of chronic kidney disease, driven by intricate interactions between mitochondrial failure and epigenetic control. The kidney is highly energy dependent and hence particularly vulnerable to mitochondrial disturbances such as decreased oxidative phosphorylation, mitochondrial reactive oxygen species (ROS) overproduction, reduced ATP production and mitochondrial DNA damage. Such changes induce oxidative stress and inflammatory reactions leading to tubular damage and fibrotic remodeling. Epigenetic processes such as DNA methylation, histone modifications and non-coding RNAs influence gene-expression programmes linked to inflammation, death, epithelial plasticity and extracellular-matrix deposition. Indeed, recent research indicates that there is reciprocal crosstalk between mitochondrial metabolism and epigenetic regulation, with metabolites such as NAD+, acetyl-CoA, α-ketoglutarate, succinate, fumarate and lactate, as well as ROS signaling, as mediators of this crosstalk. This interaction may also enhance inflammatory and fibrotic systems that drive chronic kidney disease progression. This mito-epigenetic axis has emerged as a therapeutic target. Potential strategies to mitigate renal fibrosis include SIRT1/PGC-1α signaling, AMPK activation, NRF2 antioxidant responses, epigenetic regulators (e.g., HDACs and DNMTs), and mitochondria-targeted antioxidants. Hence, this review analyses evidence according to illness, renal cell type, immunological state and translational maturity rather than considering mitochondrial and epigenetic alterations as uniform whole-kidney processes.

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BibTeX
@article{rawat2026epigenetic,
  title = {{Epigenetic and mitochondrial regulation in kidney disease: emerging mechanisms and therapeutic opportunities}},
  author = {Atul Rawat and Narayan Prasad and Chandan Komalkumar and Harshit Singh and Saurabh Chaturvedi and Sultan Ahmed and Brijendra Kumar and Ravi Shankar Kushwaha},
  journal = {Frontiers in Immunology},
  year = {2026},
  month = oct,
  doi = {10.3389/fimmu.2026.1910925},
  url = {https://doi.org/10.3389/fimmu.2026.1910925},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Epigenetic and mitochondrial regulation in kidney disease: emerging mechanisms and therapeutic opportunities
AU  - Atul Rawat
AU  - Narayan Prasad
AU  - Chandan Komalkumar
AU  - Harshit Singh
AU  - Saurabh Chaturvedi
AU  - Sultan Ahmed
AU  - Brijendra Kumar
AU  - Ravi Shankar Kushwaha
PY  - 2026
DA  - 2026/10/12
JO  - Frontiers in Immunology
DO  - 10.3389/fimmu.2026.1910925
UR  - https://doi.org/10.3389/fimmu.2026.1910925
AB  - Renal fibrosis is an important pathogenic characteristic in the course of chronic kidney disease, driven by intricate interactions between mitochondrial failure and epigenetic control. The kidney is highly energy dependent and hence particularly vulnerable to mitochondrial disturbances such as decreased oxidative phosphorylation, mitochondrial reactive oxygen species (ROS) overproduction, reduced ATP production and mitochondrial DNA damage. Such changes induce oxidative stress and inflammatory reactions leading to tubular damage and fibrotic remodeling. Epigenetic processes such as DNA methylation, histone modifications and non-coding RNAs influence gene-expression programmes linked to inflammation, death, epithelial plasticity and extracellular-matrix deposition. Indeed, recent research indicates that there is reciprocal crosstalk between mitochondrial metabolism and epigenetic regulation, with metabolites such as NAD+, acetyl-CoA, α-ketoglutarate, succinate, fumarate and lactate, as well as ROS signaling, as mediators of this crosstalk. This interaction may also enhance inflammatory and fibrotic systems that drive chronic kidney disease progression. This mito-epigenetic axis has emerged as a therapeutic target. Potential strategies to mitigate renal fibrosis include SIRT1/PGC-1α signaling, AMPK activation, NRF2 antioxidant responses, epigenetic regulators (e.g., HDACs and DNMTs), and mitochondria-targeted antioxidants. Hence, this review analyses evidence according to illness, renal cell type, immunological state and translational maturity rather than considering mitochondrial and epigenetic alterations as uniform whole-kidney processes.
SN  - 1664-3224
ER  -