Collagen type V, interstitial fibrosis and the substrate for atrial fibrillation.
Collagen type V, interstitial fibrosis and the substrate for atrial fibrillation.
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V 型胶原蛋白、间质纤维化和心房颤动的基质。
DOI：
10.1016/j.ijcha.2024.101356
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
VanWagoner,DavidR
中科院分区：
文献类型：
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作者：
VanWagoner,DavidR
AF [7]。虽然这些关联是新颖的和合理的，但常规评估这些目标的努力的效用仍然不清楚。虽然V型胶原蛋白很容易检测，但它仍然是ECM中胶原蛋白总负荷的相对小部分。在未来的研究中，评估潜在瓣膜疾病患者心房中V型胶原蛋白的相对丰度，并评估V型胶原蛋白的上游调节因子可能是有意义的。该领域的传统观点认为，纤维化一旦建立，就很难或不可能逆转。作者引用了一项小鼠研究，其中V型胶原蛋白的少量表达对心肌梗死后的瘢痕大小产生了过大的影响。胶原蛋白V的损失与瘢痕大小的增加相关，其方式为整联蛋白依赖性[8]。这项研究表明，努力减少丰富的胶原蛋白V在atria.Overall，这篇写得很好的论文从Kostin和同事提供了新的见解，我们的相对丰度和可能的作用，胶原蛋白V在人类心房的理解。共焦成像令人印象深刻。确定该蛋白质是否代表治疗干预的靶标或其丰度至关重要的ECM蛋白质将是有意义的。值得注意的是，一些患有晚期心脏瓣膜病（4+二尖瓣脱垂）的患者左心房极度扩张，而其他患者的扩张程度适中。V型胶原在扩张过程中的作用尚不清楚，AF进展时间质纤维化增加与总体心房尺寸之间的平衡也不清楚。
AF [7]. While the associations are novel and plausible, the utility of efforts to routinely assess these targets remains unclear. Although collagen type V is easily detectable, it remains a relatively small fraction of the overall burden of collagen in the ECM. It may be of interest in future studies to assess the relative abundance collagen type V in the atria of patients with underlying valvular disease, and to evaluate the upstream regulators of collagen V. The conventional wisdom in this field suggests that fibrosis, once established, is difficult or impossible to reverse. The authors cite a mouse study in which the minor expression of collagen type V had an oversized impact on scar size following myocardial infarction. Loss of collagen V was associated with increased scar size in an integrin dependent manner [8]. This study suggests that efforts to decrease the abundance of collagen V in the atria are likely contraindicated.Overall, this well-written paper from Kostin and colleagues provides new insights into our understanding of the relative abundance and possible roles of collagen V in human atria. The confocal imaging is impressive. It will be of interest to determine if this protein represents a target for therapeutic intervention, or an ECM protein whose abundance is critical. It notable that some patients with advanced valvular heart disease (4+ mitral valve prolapse) have extreme dilatation of the left atrium, while dilatation is modest in others. The role of collagen type V in the dilatation process is unclear, as is the balance between increased interstitial fibrosis and overall atrial dimensions on AF progression.