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Cardiac fibroblast

Molecular classification
Other (specialized mesenchymal cell), Stromal cell, Non-cardiomyocyte cardiac cell
01

Overview

A cardiac fibroblast is a specialized mesenchymal cell found abundantly in the heart, where it is critical for synthesizing, organizing, and remodeling the extracellular matrix (ECM), supporting tissue structure, and mediating normal and pathological responses to injury. Cardiac fibroblasts are responsible for secreting structural proteins (collagens, fibronectin), signaling molecules (cytokines, growth factors, peptides), and ECM-degrading enzymes, and play key roles in homeostasis, electrical conduction, and scar formation. Upon injury or stress, these cells differentiate into myofibroblasts, which are highly active in deposition of fibrotic tissue, contributing to stiffening, electrical disruption, and dysfunction seen in heart diseases such as heart failure, myocardial infarction, and fibrosis. Cardiac fibroblasts are not a single molecule/receptor, but a heterogeneous cell population that serves as an important therapeutic target in cardiovascular drug development. Drug targeting aims to limit or reverse pathological fibroblast activation/function while preserving essential structural maintenance of the heart [1][2][4][5][7][8].

Other names
Cardiac fibroblastsCardiac FBCardiac CFBCardiac myofibroblast (for its activated state)
02

Mechanism of action

Inhibition of fibroblast activation/myofibroblast transdifferentiation (e.g., TGF-β signaling modulators) Suppression of ECM protein synthesis or deposition Modulation of cytokine, growth factor, or peptide signaling (e.g., blockade of angiotensin II or endothelin-1) Inhibition of profibrotic signaling pathways (e.g., ALK5, TAK1, p38 MAPK inhibitors) Decrease of fibroblast-mediated inflammation and fibrosis

03

Biological functions

Extracellular matrix (ECM) synthesis and remodelingTissue structural maintenanceCell–cell communication (with cardiomyocytes, endothelial cells, smooth muscle cells)Regulation of cardiac electrical activity and conductionSecretion of cytokines, growth factors, and signaling moleculesResponse to mechanical and chemical stressScar formation and tissue repair after injuryDifferentiation into myofibroblasts
04

Disease associations

Cardiovascular diseaseMyocardial fibrosis (fibrotic remodeling)Heart failure (contributor to adverse remodeling)Myocardial infarction (post-injury scar formation)Heart valve diseaseArrhythmia (via electrical insulation or disruption)Inflammation (mediator in various cardiac injuries)
05

Safety considerations

Potential for disrupting necessary ECM maintenance (risk of ventricular wall thinning or rupture if over-inhibited)Off-target effects of broad antifibrotic therapies (e.g., TGF-β inhibition can cause immunosuppression, tissue atrophy, impaired wound healing)Arrhythmogenic potential by altering myocardial conduction propertiesPotential for unwanted interference with tissue repair mechanisms
06

Interacting drugs

Angiotensin II receptor blockers (ARBs; e.g., losartan)

7 more in the full profile.

07

Biomarkers

Collagen type I and III (COL1A1, COL3A1)Periostin (POSTN)Fibronectin (FN1)Alpha-smooth muscle actin (α-SMA/ACTA2; for myofibroblast state)Tenascin CThrombospondin-1 (THBS1)Procollagen peptides in bloodTGF-β isoforms (secreted biomarker of activation)Specific gene signatures (for fibroblast subtypes, e.g., TNC, POSTN) [3]

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