Extracellular matrix maladaptations contribute to calcific aortic valve disease progression by altering cellular and molecular signaling through matricellular, matricrine, and mechanical pathways.
Extracellular matrix changes in calcific aortic valve disease actively drive disease progression through complex signaling pathways, offering potential novel therapeutic targets.
The hallmarks of calcific aortic valve disease (CAVD) are the significant changes that occur in the organization, composition, and mechanical properties of the extracellular matrix (ECM), ultimately resulting in stiffened stenotic leaflets that obstruct flow and compromise cardiac function. Increasing evidence suggests that ECM maladaptations are not simply a result of valve cell dysfunction; they also contribute to CAVD progression by altering cellular and molecular signaling. In this review, we summarize the ECM changes that occur in CAVD. We also discuss examples of how the ECM influences cellular processes by signaling through adhesion receptors (matricellular signaling), by regulating the presentation and availability of growth factors and cytokines to cells (matricrine signaling), and by transducing externally applied forces and resisting cell-generated tractional forces (mechanical signaling) to regulate a wide range of pathological processes, including differentiation, fibrosis, calcification, and angiogenesis. Finally, we suggest areas for future research that should lead to new insights into bidirectional cell-ECM interactions in the aortic valve, their contributions to homeostasis and pathobiology, and possible targets to slow or prevent the progression of CAVD.
Chen et al. (Fri,) conducted a review in Calcific Aortic Valve Disease. Extracellular matrix (ECM) changes was evaluated. Extracellular matrix maladaptations contribute to calcific aortic valve disease progression by altering cellular and molecular signaling through matricellular, matricrine, and mechanical pathways.