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ResearchIn-Press PreviewNephrologyPublic Health Open Access | 10.1172/jci.insight.203039

Kidney fibrosis is mediated by GARP-restricted TGF-β activation in fibroblasts

Yintong Chen,1 Weiwei Xu,1 Jieli Yu,1 Pei Deng,1 Nianping Liu,2 Yinyin Li,1 Hui Zhou,1 Hong Zhou,1 Jianchuan Wang,3 Bo Zhao,4 Florian Winau,5 Fan Fan Hou,1 and Yu Hu1

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Chen, Y. in: PubMed | Google Scholar

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Xu, W. in: PubMed | Google Scholar

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Yu, J. in: PubMed | Google Scholar

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Deng, P. in: PubMed | Google Scholar

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Liu, N. in: PubMed | Google Scholar

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Li, Y. in: PubMed | Google Scholar

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Zhou, H. in: PubMed | Google Scholar

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Zhou, H. in: PubMed | Google Scholar

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Wang, J. in: PubMed | Google Scholar

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Zhao, B. in: PubMed | Google Scholar

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Winau, F. in: PubMed | Google Scholar

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Hou, F. in: PubMed | Google Scholar |

1Division of Nephrology, Southern Medical University, Guangzhou, China

2Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

3School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China

4Molecular Cancer Research Center, Sun Yat-sen University, Guangzhou, China

5Department of Pediatrics, Harvard Medical School, Boston, United States of America

Find articles by Hu, Y. in: PubMed | Google Scholar

Published September 17, 2026 - More info

JCI Insight. https://doi.org/10.1172/jci.insight.203039.
Copyright © 2026, Chen et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published September 17, 2026 - Version history
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Abstract

TGF-β is a central driver of kidney fibrosis, a common pathological hallmark of chronic kidney disease (CKD). Initiation of TGF-β signaling requires not only its synthesis but also the conversion of latent TGF-β to its bioactive form. However, the mechanisms governing TGF-β activation in the kidney and their contribution to kidney fibrosis remain poorly understood. Glycoprotein A repetitions predominant (GARP) anchors latent TGF-β on the cell surface and facilitates its bioactive release. Here, we show that GARP-mediated TGF‐β activation promotes kidney fibrosis. GARP was upregulated in both human and mouse CKD kidneys, predominantly in fibroblasts, and was induced by TNF in an NF-kB-dependent fashion. In multiple mouse models of kidney fibrosis, either global or fibroblast-specific deletion of GARP significantly reduced fibrosis. Mechanistically, GARP enables sustained production of active TGF-β, thereby amplifying fibroblast stimulation. Deletion of GARP in kidney fibroblasts lowered active TGF-β levels and attenuated fibroblast activation, whereas GARP overexpression enhanced TGF-β signaling. Notably, tamoxifen-induced deletion of GARP after fibrosis onset attenuated kidney fibrosis. Together, our findings identify GARP-mediated release of active TGF‐β as a critical step in sustaining fibroblast activation during kidney fibrosis and highlight GARP as a promising therapeutic target for CKD.

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