Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil.
NUCEL (Cell and Molecular Therapy Center), University of São Paulo, São Paulo, Brazil.
Tissue Eng Part B Rev. 2022 Jun;28(3):517-530. doi: 10.1089/ten.TEB.2020.0357. Epub 2021 Jun 14.
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive disease with significant gas exchange impairment owing to exaggerated extracellular matrix (ECM) deposition and myofibroblast activation. IPF has no cure, and although nintedanib and pirfenidone are two approved medications for symptom management, the total treatment cost is exuberant and prohibitive to a global uninsured patient population. New therapeutic alternatives with moderate costs are needed to treat IPF. ECM hydrogels derived from decellularized lungs are cost-effective therapeutic candidates to treat pulmonary fibrosis because of their reported antioxidant properties. Oxidative stress contributes to IPF pathophysiology by damaging macromolecules, interfering with tissue remodeling, and contributing to myofibroblast activation. Thus, preventing oxidative stress has beneficial outcomes in IPF. For this purpose, this review describes ECM hydrogel's properties to regulate oxidative stress and tissue remodeling in IPF. Impact statement Idiopathic pulmonary fibrosis (IPF) is a disease without a cure and with limited treatment options. At present, approved medications are expensive and pose a huge socioeconomic challenge to patients who depend on them. Affordability and effectiveness are desirable qualities for new therapeutic alternatives. Extracellular matrix hydrogels have properties that distinguish them other biomaterials, and it has been studied in the context of fibrosis-related molecular mechanisms. This review examines the biological processes involved in IPF and suggests developing a hydrogel-based treatment option for patients with IPF.
特发性肺纤维化（IPF）是一种慢性进行性疾病，由于细胞外基质（ECM）沉积和肌成纤维细胞激活，导致明显的气体交换受损。IPF 无法治愈，尽管尼达尼布和吡非尼酮是两种用于症状管理的批准药物，但总治疗费用过高，对于没有保险的全球患者群体来说是无法承受的。需要具有适度成本的新治疗选择来治疗 IPF。脱细胞肺衍生的 ECM 水凝胶是一种具有成本效益的治疗肺纤维化的候选药物，因为它们具有报道的抗氧化特性。氧化应激通过破坏大分子、干扰组织重塑和促进肌成纤维细胞激活来导致 IPF 的病理生理学。因此，预防氧化应激对 IPF 有有益的结果。为此，本综述描述了 ECM 水凝胶调节 IPF 中氧化应激和组织重塑的特性。 影响说明 特发性肺纤维化（IPF）是一种无法治愈且治疗选择有限的疾病。目前，批准的药物价格昂贵，对依赖这些药物的患者构成了巨大的社会经济挑战。可负担性和有效性是新治疗选择的理想特性。细胞外基质水凝胶具有与其他生物材料不同的特性，并且已经在与纤维化相关的分子机制的背景下进行了研究。本综述检查了与 IPF 相关的生物学过程，并提出了为 IPF 患者开发基于水凝胶的治疗选择。
