Changes in profibrotic activity in cardiovascular diseases

The myocardium consists of several types of cells: cardiomyocytes, cardiac fibroblasts, endothelial cells and smooth muscle cells. Fibroblasts are cells of mesenchymal origin and are present in all tissues in the body. Cardiac damage can activate available CFBs, provoke transformation of endothelial or epithelial cells into fibroblasts, or induce the production of CFBs from hematopoietic cells and bone marrow. The change in ECM is a key point in the remodeling of the heart in response to the disease process. Disruption of the reticular structure of the ECM alters the connection between myocardial cells and blood vessels, thereby disrupting the structure and function of the heart muscle. Type I and III collagen fibrils are the predominant part of the ECM of the heart. They are synthesized as procollagen, which is converted to a mature collagen molecule. Procollagen type I propeptide (PICP), amino-terminal propeptide type I procollagen (PINP) and N terminal type III collagen peptide (PIIINP) are released in proportional amounts in the synthesis of collagen types I and III and can be used as serum markers for these processes. On the other hand the differentiation from CFBs to myoFB is supported by the transforming growth factor beta (TGF-β), connective tissue growth factor (CTGF), a number of cytokines in the ECM and others. The scientific community is faced with the question of which biomarkers to use to identify the early stages of development of cardiac fibrosis, as well as how to assess the degree of progression of this pathological process.