AUTHOR=Jiang Wenyang , Xiong Yuyan , Li Xiaosong , Yang Yuejin 

TITLE=Cardiac Fibrosis: Cellular Effectors, Molecular Pathways, and Exosomal Roles

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.715258

DOI=10.3389/fcvm.2021.715258

ISSN=2297-055X

ABSTRACT=Cardiac fibrosis, a common pathophysiologic process in most heart diseases, refers to an excess of extracellular matrix (ECM) deposition by cardiac fibroblasts (CFs), which can lead to cardiac dysfunction and heart failure subsequently. Not only CFs, there are several other cell types including macrophages, endothelial cells, participated in the process of cardiac fibrosis via different molecular pathways. Exosomes, ranging in 30-150 nm size, has been confirmed to play an essential role in cellular communications by its bioactive contents, which is currently a hot area to explore pathobiology and therapeutic strategy in multiple pathophysiologic process including cardiac fibrosis. Cardioprotective factors such as RNAs and proteins packaged in exosomes make it an excellent cell-free system to improve cardiac function without significant immune response. Emerging evidence indicates that targeting selective molecules in cell-derived exosomes could be appealing therapeutic treatments in cardiac fibrosis. In this review, we summarize the current understandings of cellular effectors, molecular pathways and exosomal roles in cardiac fibrosis.