The Current State of Extracellular Matrix Therapy for Ischemic Heart Disease

Abstract

The extracellular matrix (ECM) is a three-dimensional, acellular network of diverse structural and nonstructural proteins embedded within a gel-like ground substance composed of glycosaminoglycans and proteoglycans. The ECM serves numerous roles that vary according to the tissue in which it is situated. In the myocardium, the ECM acts as a collagen-based scaffold that mediates the transmission of contractile signals, provides means for paracrine signaling, and maintains nutritional and immunologic homeostasis. Given this spectrum, it is unsurprising that both the composition and role of the ECM has been found to be modulated in the context of cardiac pathology. Myocardial infarction (MI) provides a familiar example of this; the ECM changes in a way that is characteristic of the progressive phases of post-infarction healing. In recent years, this involvement in infarct pathophysiology has prompted a search for therapeutic targets: if ECM components facilitate healing, then their manipulation may accelerate recovery, or even reverse pre-existing damage. This possibility has been the subject of numerous efforts involving the integration of ECM-based therapies, either derived directly from biologic sources or bioengineered sources, into models of myocardial disease. In this paper, we provide a thorough review of the published literature on the use of the ECM as a novel therapy for ischemic heart disease, with a focus on biologically derived models, of both the whole ECM and the components thereof.

Exploring Electrospun Scaffold Innovations in Cardiovascular Therapy: A Review of Electrospinning in Cardiovascular Disease

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Changes in various forms of fibronectin in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass

“…Cardiopulmonary bypass surgery induces remodelling of extracellular matrix and repair processes. Matrix metalloproteinases (MMPs) released from inflammatory and endogenous cells degrade ECM, disengage integrins, and stimulate reparative fibrosis [3,4]. Fibronectin (FN), an adhesive glycoprotein that is a key component of the extracellular matrix, is widely distributed in human body fluids.…”