Why the study?
Myocardial fibrosis is mediated by molecular pathways that represent potential targets for novel therapeutic interventions, focusing on TGF-beta, cTGF, and Gal-3.
Do emerging anti-fibrotic agents targeting TGF-β, cTGF, and Gal-3 improve cardiac function and reduce fibrosis in preclinical models and clinical trials?
Do emerging anti-fibrotic agents targeting TGF-β, cTGF, and Gal-3 improve cardiac function and reduce fibrosis in preclinical models and clinical trials?
While preclinical models show promise for targeted anti-fibrotic therapies in improving cardiac function, there remains a significant gap in clinical trial translation.
Preclinical anti-fibrotic promise warrants no practice change; leaves open need for clinical trials and targeted molecules.
INTRODUCTION: Myocardial fibrosis is a remarkably dynamic process mediated by different molecular pathways that represent potential targets of novel therapeutic interventions. Transforming Growth Factor-beta (TGF-β), connective Tissue Growth Factor (cTGF) and Galectin-3 (Gal-3) represent the most promising targets on which research has been currently focusing. AREA COVERED: This review initially discusses those drugs used in clinical practice for their anti-fibrotic properties and later examines emerging pathway-specific agents in preclinical and clinical development [phase I and II-concluded or ongoing trials]. We performed a PubMed, Embase and Google Scholar research including original articles, systematic reviews, ongoing and completed trials using combinations of keywords such as 'myocardial fibrosis', 'reverse remodeling', 'RAAs', 'therapy'. EXPERT OPINION: A variety of preclinical evidences suggest that new drugs and molecules are potentially useful to target cardiac fibrosis and improve left ventricular function, reduce infarct size and scars, delay incident heart failure and cardiac dysfunction in animal models. However, there are very few clinical trials investigating the effect of such drugs in this setting, as well as a lack of new engineered molecules for specific targets.
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Spoladore et al. (2020) studied this question.
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