Connective Tissue Growth Factor Inhibition Enhances Cardiac Repair and Limits Fibrosis After Myocardial Infarction

JACC Basic Transl Sci. 2019 Feb 25;4(1):83-94. doi: 10.1016/j.jacbts.2018.10.007. eCollection 2019 Feb.

Abstract

Myocardial infarction (MI)-induced cardiac fibrosis attenuates cardiac contractile function, and predisposes to arrhythmias and sudden cardiac death. Expression of connective tissue growth factor (CTGF) is elevated in affected organs in virtually every fibrotic disorder and in the diseased human myocardium. Mice were subjected to treatment with a CTGF monoclonal antibody (mAb) during infarct repair, post-MI left ventricular (LV) remodeling, or acute ischemia-reperfusion injury. CTGF mAb therapy during infarct repair improved survival and reduced LV dysfunction, and reduced post-MI LV hypertrophy and fibrosis. Mechanistically, CTGF mAb therapy induced expression of cardiac developmental and/or repair genes and attenuated expression of inflammatory and/or fibrotic genes.

Keywords: CTGF, connective tissue growth factor; ECM, extracellular matrix; ERK, extracellular signal-regulated kinase; FB, fibroblast; HF, heart failure; I/R, ischemia−reperfusion; Ig, immunoglobulin; JNK, c-Jun N-terminal kinase; LV, left ventricular; MI, myocardial infarction; TGF, transforming growth factor; connective tissue growth factor monoclonal antibody; fibrosis; heart failure; ischemia−reperfusion injury; left ventricle; mAb, monoclonal antibody; myocardial infarction.