Zhao Wen, Angspatt Apichai, Kitkumthorn Nakarin, Meevassana Jiraroch
Program of Clinical Sciences, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Division of Plastic and Reconstructive Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Inflamm Res. 2025 Aug 9;18:10777-10793. doi: 10.2147/JIR.S541656. eCollection 2025.
Fibrosis is characterised by an excessive response to tissue injury during wound healing, resulting in excessive scarring, which can affect any organ and lead to deformity or death. Fibrogenesis is a highly orchestrated process in which extracellular matrix deposition becomes unstructured, disrupting normal tissue architecture and subsequently impairing proper organ function through complex molecular signals and cellular responses. Inflammation is an important trigger for both regeneration and fibrosis after tissue damage-particularly due to inflammatory cytokines released by various recruited and activated immune cells-which can provoke an excessive inflammatory response in a short time. The cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) pathway has emerged as a key mediator of inflammation in the context of infection, cellular stress, tissue damage, and fibrosis. This reflects its capacity to sense and regulate cellular responses to ubiquitous danger-associated molecular patterns, mainly microbial or host-derived DNA. The cGAS-STING pathway plays a pivotal role in the development and progression of fibrotic diseases by linking cellular stress and DNA damage to chronic inflammation and fibroblast activation, thereby driving pathological tissue remodeling and extracellular matrix accumulation. However, a systematic summary of cGAS-STING in fibrotic diseases is lacking. Therefore, this review focuses on the effects and molecular mechanisms of cGAS-STING signalling in fibrotic diseases. We outline the principal elements of the cGAS-STING signalling cascade and discuss the mechanisms underlying the association of cGAS-STING activity with fibrosis in different organs. Finally, we elucidate the recently developed cGAS and STING antagonists and summarise their potential clinical applications in fibrotic diseases.
纤维化的特征是在伤口愈合过程中对组织损伤产生过度反应,导致过度瘢痕形成,这可能影响任何器官并导致畸形或死亡。纤维生成是一个高度协调的过程,在此过程中细胞外基质沉积变得无序,破坏正常组织结构,随后通过复杂的分子信号和细胞反应损害器官的正常功能。炎症是组织损伤后再生和纤维化的重要触发因素,特别是由于各种募集和激活的免疫细胞释放的炎性细胞因子,这可能在短时间内引发过度的炎症反应。环磷酸鸟苷-腺苷酸合成酶(cGAS)-干扰素基因刺激因子(STING)途径已成为感染、细胞应激、组织损伤和纤维化背景下炎症的关键介质。这反映了其感知和调节细胞对普遍存在的危险相关分子模式(主要是微生物或宿主来源的DNA)反应的能力。cGAS-STING途径通过将细胞应激和DNA损伤与慢性炎症和成纤维细胞激活联系起来,在纤维化疾病的发生和发展中起关键作用,从而驱动病理性组织重塑和细胞外基质积累。然而,目前缺乏对纤维化疾病中cGAS-STING的系统总结。因此,本综述重点关注cGAS-STING信号在纤维化疾病中的作用和分子机制。我们概述了cGAS-STING信号级联的主要元件,并讨论了cGAS-STING活性与不同器官纤维化关联的潜在机制。最后,我们阐明了最近开发的cGAS和STING拮抗剂,并总结了它们在纤维化疾病中的潜在临床应用。
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