Hydrogen Sulfide in Kidney Diseases: A Novel Pharmacotherapy

This is the first book to present the beneficial effects of hydrogen sulfide in the treatment of various kidney pathologies. Hydrogen sulfide (H2S), a gas with a distinctive smell of rotten eggs, was known for over three centuries for its toxicity and death at high concentrations especially among agricultural and industrial workers. This is due to its ability to reversibly antagonize complex IV of the mitochondrial electron transport chain. However, studies over the past two decades have shown that H2S has risen above its historic notorious label and has received significant experimental attention as an endogenously produced gaseous signaling molecule that plays an important role in cellular homeostasis and influences a myriad of physiological and pathological processes at low concentrations. Its production is enzymatically regulated and has specific molecular targets. Several recent in vitro and in vivo studies have demonstrated that at low micromolar concentrations, H2S exhibits important therapeutic characteristics that target multiple molecular pathways and thereby preventing the development and progression of several pathologies.

This beneficial effect of H2S suggests that it may meet the demand for alternative and/or additional therapeutic agents against various renal pathologies in which reduced levels of renal and plasma H2S were observed. Interestingly, while the distribution of H2S-producing enzymes is tissue-specific, they are abundantly expressed in the glomeruli and in the brush border and cytoplasm of epithelial cells of the renal tubules and in the peritubular capillaries. This makes the kidney a rich source of endogenous H2S production. From pre-clinical and clinical perspectives, this book is topical and timely, and seeks to lay the foundation for future clinical applications of H2S in nephrology.