Frangogiannis Nikolaos G
J Clin Invest. 2017 May 1;127(5):1600-1612. doi: 10.1172/JCI87491.
The cardiac extracellular matrix (ECM) not only provides mechanical support, but also transduces essential molecular signals in health and disease. Following myocardial infarction, dynamic ECM changes drive inflammation and repair. Early generation of bioactive matrix fragments activates proinflammatory signaling. The formation of a highly plastic provisional matrix facilitates leukocyte infiltration and activates infarct myofibroblasts. Deposition of matricellular proteins modulates growth factor signaling and contributes to the spatial and temporal regulation of the reparative response. Mechanical stress due to pressure and volume overload and metabolic dysfunction also induce profound changes in ECM composition that contribute to the pathogenesis of heart failure. This manuscript reviews the role of the ECM in cardiac repair and remodeling and discusses matrix-based therapies that may attenuate remodeling while promoting repair and regeneration.
心脏细胞外基质（ECM）不仅提供机械支持，还在健康和疾病状态下传导重要的分子信号。心肌梗死后，ECM的动态变化驱动炎症和修复过程。生物活性基质片段的早期产生激活促炎信号传导。高度可塑性临时基质的形成促进白细胞浸润并激活梗死区肌成纤维细胞。基质细胞蛋白的沉积调节生长因子信号传导，并有助于修复反应的时空调节。压力和容量超负荷以及代谢功能障碍引起的机械应力也会导致ECM组成发生深刻变化，进而促进心力衰竭的发病机制。本文综述了ECM在心脏修复和重塑中的作用，并讨论了基于基质的疗法，这些疗法可能在促进修复和再生的同时减轻重塑。
