IMR Press / RCM / Volume 24 / Issue 8 / DOI: 10.31083/j.rcm2408226
Open Access Review
A Review of Therapeutic Strategies against Cardiac Fibrosis: From Classical Pharmacology to Novel Molecular, Epigenetic, and Biotechnological Approaches
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1 Department of Medical Surgical Sciences and Biotechnologies, Sapienza University, 04100 Latina, Italy
2 Institute of Biochemistry and Cell Biology, National Council of Research (IBBC-CNR), 00015 Monterotondo, Italy
3 Mediterranea Cardiocentro, 80122 Napoli, Italy
*Correspondence: isotta.chimenti@uniroma1.it (Isotta Chimenti)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(8), 226; https://doi.org/10.31083/j.rcm2408226
Submitted: 22 February 2023 | Revised: 6 April 2023 | Accepted: 6 May 2023 | Published: 8 August 2023
(This article belongs to the Special Issue Tissue Repair and Regeneration in Heart Failure)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Cardiovascular diseases are the first cause of death worldwide, with a heavy social and economic impact. They include a wide range of pathological conditions, among which cardiac fibrosis represents a common pathogenetic hallmark. The fibrotic process is driven by cardiac mesenchymal stromal cells, namely fibroblasts, which become activated, proliferate, and differentiate into myofibroblasts in response to several stimuli, in the end secreting extracellular matrix proteins, and mediating cardiac tissue remodelling and stiffening. A specific therapy for the exclusive treatment of cardiac fibrosis is still lacking. Given the growing quest for reducing the burden of cardiovascular diseases, there is increasing interest in the search for new effective anti-fibrotic therapies. In this review, we will briefly summarize the limited pharmacological therapies known to act, at least in part, against cardiac fibrosis. Then we will present novel potential active molecules, molecular targets, and biotechnological approaches emerged in the last decade, as possible future therapeutic strategies for cardiac fibrosis, with a specific focus on targeting fibroblast activation and function.

Keywords
cardiac fibrosis
cardiac remodeling
biological therapies
cardiac fibroblasts
cardiac stromal cells
non-coding RNAs
RNA-therapeutics
precision medicine
Funding
RM12117A805ED2FD/Sapienza University of Rome
RG11916B85CDBF76/Sapienza University of Rome
RG1221816BC8E766/Italian Health Ministry
A0375-2020-36621/Regione Lazio
AR12218167E8FA71/Sapienza University of Rome
Figures
Fig. 1.
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