Mediators and signaling pathways in myocardial fibrosis

Myocardial fibrosis is closely associated with severe cardiovascular diseases, characterized by increased mortality rates worldwide. The development of myocardial fibrosis is based on the differentiation of fibroblasts into myofibroblasts, which synthesize components of the extracellular matrix in excess. A key regulator of fibroblast differentiation into myofibroblasts is transforming growth factor-beta. In recent years, close attention in the pathogenesis of fibrosis has been given to other growth factors – neurotrophins. It was recently discovered that fibroblasts express brain-derived neurotrophic factor (BDNF), and its receptors are involved in the pathogenesis of fibrosis of various organs and tissues. The role of BDNF and its receptors in the pathogenesis of myocardial fibrosis is just beginning to be studied. This review summarizes the information available in the literature (2019-2023) on the pathophysiological and pathogenetic mechanisms of the relationship between BDNF and cardiac fibrosis. Data presented in the literature showed that the mechanisms of action of BDNF in the cardiovascular system and the pathogenesis of cardiac fibrosis have common points of intersection, which makes this neurotrophin a promising therapeutic target for cardiac fibrosis. Further investigation of these aspects will allow the use of various external effects of BDNF to develop technology for the prevention of cardiac fibrosis.