Current experimental and early investigational agents for cardiac fibrosis: where are we at?

Autor: Ciampi CM; Health Science Department, University of Milan Bicocca, Milano, Italy., Sultana A; Health Science Department, University of Milan Bicocca, Milano, Italy., Ossola P; Health Science Department, University of Milan Bicocca, Milano, Italy., Farina A; Division of Cardiology, Alessandro Manzoni Hospital, ASST- Lecco, Italy., Fragasso G; Heart Failure Unit Head, Division of Cardiology, IRCCS Vita-Salute San Raffaele University Hospital, Milan, Italy., Spoladore R; Division of Cardiology, Alessandro Manzoni Hospital, ASST- Lecco, Italy.
Jazyk: angličtina
Zdroj: Expert opinion on investigational drugs [Expert Opin Investig Drugs] 2024 Apr; Vol. 33 (4), pp. 389-404. Date of Electronic Publication: 2024 Mar 06.
DOI: 10.1080/13543784.2024.2326024
Abstrakt: Introduction: Myocardial fibrosis (MF) is induced by factors activating pro-fibrotic pathways such as acute and prolonged inflammation, myocardial ischemic events, hypertension, aging process, and genetically-linked cardiomyopathies. Dynamics and characteristics of myocardial fibrosis development are very different. The broad range of myocardial fibrosis presentations suggests the presence of multiple potential targets.
Area Covered: Heart failure treatment involves medications primarily aimed at counteracting neurohormonal activation. While these drugs have demonstrated efficacy against MF, not all specifically target inflammation or fibrosis progression with some exceptions such as RAAS inhibitors. Consequently, new therapies are being developed to address this issue. This article is aimed to describe anti-fibrotic drugs currently employed in clinical practice and emerging agents that target specific pathways, supported by evidence from both preclinical and clinical studies.
Expert Opinion: Despite various preclinical findings suggesting the potential utility of new drugs and molecules for treating cardiac fibrosis in animal models, there is a notable scarcity of clinical trials investigating these effects. However, the pathology of damage and repair in the heart muscle involves a complex network of interconnected inflammatory pathways and various types of immune cells. Our comprehension of the positive and negative roles played by specific immune cells and cytokines is an emerging area of research.
Databáze: MEDLINE