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1、Associate Editor: Barbara McDermott Cardiac fi broblasts: At the heart of myocardial remodeling Karen E. Porter, Neil A. Turner Multidisciplinary Cardiovascular Research Centre (MCRC) Division of Cardiovascular and Neuronal Remodelling, Leeds Institute of Genetics, Health and Therapeutics (LIGHT), U
2、niversity of Leeds, Leeds LS2 9JT, UK a b s t r a c ta r t i c l ei n f o Keywords: Heart Fibroblast Myofi broblast Remodeling Therapeutic agents Cardiac fi broblasts are the most prevalent cell type in the heart and play a key role in regulating normal myocardial function and in the adverse myocard
3、ial remodeling that occurs with hypertension, myocardial infarction and heart failure. Many of the functional effects of cardiac fi broblasts are mediated through differentiation to a myofi broblast phenotype that expresses contractile proteins and exhibits increased migratory, proliferative and sec
4、retory properties. Cardiac myofi broblasts respond to proinfl ammatory cytokines (e.g. TNF, IL-1, IL-6, TGF-), vasoactive peptides (e.g. angiotensin II, endothelin-1, natriuretic peptides) and hormones (e.g. noradrenaline), the levels of which are increased in the remodeling heart. Their function is
5、 also modulated by mechanical stretch and changes in oxygen availability (e.g. ischaemia reperfusion). Myofi broblast responses to such stimuli include changes in cell proliferation, cell migration, extracellular matrix metabolism and secretion of various bioactive molecules including cytokines, vas
6、oactive peptides and growth factors. Several classes of commonly prescribed therapeutic agents for cardiovascular disease also exert pleiotropic effects on cardiac fi broblasts that may explain some of their benefi cial outcomes on the remodeling heart. These include drugs for reducing hypertension
7、(ACE inhibitors, angiotensin receptor blockers, beta-blockers), cholesterol levels (statins, fi brates) and insulin resistance (thiazolidinediones). In this review, we provide insight into the properties of cardiac fi broblasts that underscores their importance in the remodeling heart, including the
8、ir origin, electrophysiological properties, role in matrix metabolism, functional responses to environmental stimuli and ability to secrete bioactive molecules. We also review the evidence suggesting that certain cardiovascular drugs can reduce myocardial remodeling specifi cally via modulatory effe
9、cts on cardiac fi broblasts. 2009 Elsevier Inc. All rights reserved. Contents 1.Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .256 2. Cardiac fi broblasts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
10、56 3. Cardiac fi broblasts are key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258 4. How cardiac fi broblasts respond to environmental stimuli . . . . . . . . . . . . . . . . . . . . . . . . .261 5. Cardiac fi broblasts are a key source of bioactive molecules. . .
11、 . . . . . . . . . . . . . . . . . . . . . .264 6. Therapeutic modulation of cardiac fi broblast function . . . . . . . . . . . . . . . . . . . . . . . . . . .266 7.Summary and future directions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270 Acknowledgments . . . . . .
12、 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .272 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .272 Pharmacology -SMA, Alpha smooth muscle actin; ACE, angiotensin converting enzyme; Ang II, angiotensin
13、II; ANP, A-type (atrial) natriuretic peptide; ARB, angiotensin receptor blocker; AT1R/AT2R, angiotensin receptor type 1/2; -AR, beta adrenergic receptor; BM, bone marrow; BNP, B-type (brain) natriuretic peptide; CF, cardiac fi broblast; CNP, C-type natriuretic peptide; CTGF, connective tissue growth
14、 factor; ECM, extracellular matrix; EPDC, epicardial-derived cells; ERK, extracellular signal-regulated kinase; ET-1, endothelin-1; ETA/ETB, endothelin receptor type A/B; FGF, fi broblast growth factor; FPP, farnesyl pyrophosphate; GGPP, geranylgeranyl pyrophosphate; HF, heart failure; HMG-CoA, 3-hy
15、droxy-3-methylglutaryl coenzyme A; IL-1, interleukin-1; IL-6, interleukin-6; ISO, isoproterenol; MAPK, mitogen-activated protein kinase; MI, myocardial infarction; MMP, matrix metalloproteinase; MT-MMP, membrane-type matrix metalloproteinase; MTT, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium
16、 bromide; myoFb, myofi broblast; NA, noradrenaline; NF-B, nuclear factor kappa B; PDGF, platelet-derived growth factor; PI3K, phosphatidylinositol-3-kinase; PPAR, peroxisome proliferator-activated receptor; RAS, reninangiotensin system; ROS, reactive oxygen species; TGF-, transforming growth factor-beta; TIMP, tissue inhibitor of metalloproteinase; TNF, tumor necrosis factor alpha; TZD, thiazolidinedione; VEGF, vascular endothelial growth factor. Corresponding authors. Division of
