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Biomechanical/biochemical factors contributing to cardiac fibrosis in the heart and engineered cardiac tissue
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VAHID NIKOUI, GOLROKH MALIHI, ELLIOT L. ELSON, VAHID NIKOUI
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| Abstract:
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Almost 6 million people in the United States have heart failure and the primary underlying factor is cardiac fibrosis. Cardiac fibrosis causes about 50% of deaths in developed world. The cardiac fibroproliferative diseases are characterized by abnormal proliferation and accumulation of cardiac fibroblasts and excessive deposition of extracellular matrix. While the treatment provided sufficient blood flow to the heart, yet it was not effective in the improvement of fibrosis. Clinical and preclinical studies have been targeting various systems such as the renin-angiotensin system, transforming growth factor-beta, and endothelin, which are currently in different stages of development. Creating a suitable model system to further clarify the disease process and testing new compounds for the treatment of cardiac fibrosis has led to fabrication of an innovative human engineered heart tissue (hEHT) developed and improved for more than two decades to serve as a surrogate for human intact tissue for the purpose of organ regeneration, diseases modeling and drug screening tests for different treatment options. Different pathways should be evaluated by multiple pharmacological/biochemical studies to direct the process of healing towards tissue regeneration instead of development of fibroproliferative disease states. The aim of this review is to discuss the inhibition of different pathways that lead to fibrosis and may direct the fibro-proliferative process in the heart to a state of tissue regeneration which could best be studied through screening using human engineered heart tissue (hEHT). This manipulation of mechanical properties or mechanical forces that control tissue repair system allows to study the mechanism and treatment strategies for cardiac fibrosis.
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| Keyword:
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Fibrosis; heart; tissue engineering; cardiovascular.
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