Editorial comment
Mast cells: Promoters of myocardial fibrosis in hypertensive heart disease?
Mastócitos: promotores da fibrose miocárdica na doença hipertensiva cardíaca?
Rosa Henriques de Gouveia
Pathological Anatomy, Instituto Nacional de Medicina Legal e Ciências Forenses, Coimbra, Portugal
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"tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "97" "paginaFinal" => "98" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Rosa Henriques de Gouveia" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Rosa Henriques de" "apellidos" => "Gouveia" "email" => array:1 [ 0 => "rhgouveia@mail.telepac.pt" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Pathological Anatomy, Instituto Nacional de Medicina Legal e Ciências Forenses, Coimbra, Portugal" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Mastócitos: promotores da fibrose miocárdica na doença hipertensiva cardíaca?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Myocardial fibrosis – perivascular, interstitial or replacement (scar)<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> – is the endpoint of various pathological settings, often leading to dismal outcomes, including heart failure, arrhythmias and sudden death. In hypertensive heart disease, patterns of perivascular and interstitial myocardial fibrosis are common and may easily be shown and graded, in formalin-fixed samples, with histochemical stains such as Masson trichrome, elastic Van Gieson, or picrosirius red.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Experimental and human studies<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> have demonstrated that myocardial fibrosis is the result of various promoters, among which are mast cells.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3–10</span></a> Discovered and named by the Nobel prize-winning German physician Paul Ehrlich in 1878,<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> mast cells are immune cells derived from bone marrow precursors and resident in tissues. They are usually classified as typical if located in connective tissue such as the myocardium, or atypical if located elsewhere, and as MCT if their granules contain tryptase, MCC if they contain chymase or MCTC if they contain both proteases.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,4</span></a> Anti-chymase or anti-tryptase antibodies are used for immunohistochemical identification of mast cells in situ.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Mast cells are also known have a wide range of mediators (histamine, cytokines, growth factors and vasoactive agents) that affect tissue remodeling as pro- or anti-fibrotic agents.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4–7</span></a> The effect of cardiac mast cells on myocardial fibrosis may result both from degranulation and from de novo secretion of mediators common to other cells, including tumor necrosis factor alpha and beta, interleukin 4 and platelet-derived growth factor, as well as from the roles of chymase and/or tryptase.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The fibrogenic action of chymase may follow two pathways: the formation of angiotensin II through activation of the angiotensin-converting enzyme-independent chymase pathway, and activation of matrix metalloproteinases.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,4,7</span></a> Tryptase activates fibroblast proliferation and collagen I synthesis, mainly by activating protease-activated receptor-2.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">There is controversy concerning the pro-fibrotic and anti-fibrotic phenotypes of mast cells: whether the phenotypes can switch depending on the environment and genetics, and whether fibrotic tissue can regress as a consequence of a switch to the anti-fibrotic version; what are the key points of therapeutic intervention; and other questions.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Some authors point out limitations in research into human cardiac fibrosis and its relation to mast cells, due both to the characteristics of the samples used, whether obtained from biopsy or autopsy, and to the difficulty in obtaining normal control tissue.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Myocardial biopsies are limited in their size and location, although if morphological alterations are identified and appropriate complementary techniques are applied, useful data may be obtained. Furthermore, despite the difficulties in preserving autopsy material, if basic preservative measures are routinely applied, it may provide large quantities of disease samples and normal controls, as exemplified by the study by Juliano et al. published in this issue of the <span class="elsevierStyleItalic">Journal</span>.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:2 [ "identificador" => "xack462757" "titulo" => "Acknowledgments" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiac fibrosis: cell biological mechanisms, molecular pathways and therapeutic opportunities" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.N. 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Marone" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Int J Mol Sci" "fecha" => "2019" "volumen" => "20" "paginaInicial" => "4397" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack462757" "titulo" => "Acknowledgments" "texto" => "<p id="par0045" class="elsevierStylePara elsevierViewall">To Prof. Doutor Nuno Cardim for the invitation to write this article.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003900000002/v1_202005210836/S2174204920301380/v1_202005210836/en/main.assets" "Apartado" => array:4 [ "identificador" => "9917" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003900000002/v1_202005210836/S2174204920301380/v1_202005210836/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204920301380?idApp=UINPBA00004E" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 6 | 10 |
| 2024 October | 38 | 45 | 83 |
| 2024 September | 44 | 23 | 67 |
| 2024 August | 47 | 31 | 78 |
| 2024 July | 24 | 36 | 60 |
| 2024 June | 24 | 18 | 42 |
| 2024 May | 27 | 16 | 43 |
| 2024 April | 21 | 24 | 45 |
| 2024 March | 25 | 20 | 45 |
| 2024 February | 19 | 21 | 40 |
| 2024 January | 23 | 24 | 47 |
| 2023 December | 23 | 28 | 51 |
| 2023 November | 25 | 24 | 49 |
| 2023 October | 12 | 11 | 23 |
| 2023 September | 25 | 18 | 43 |
| 2023 August | 22 | 13 | 35 |
| 2023 July | 16 | 6 | 22 |
| 2023 June | 20 | 12 | 32 |
| 2023 May | 29 | 27 | 56 |
| 2023 April | 26 | 6 | 32 |
| 2023 March | 23 | 18 | 41 |
| 2023 February | 25 | 16 | 41 |
| 2023 January | 15 | 15 | 30 |
| 2022 December | 30 | 17 | 47 |
| 2022 November | 33 | 21 | 54 |
| 2022 October | 37 | 24 | 61 |
| 2022 September | 24 | 40 | 64 |
| 2022 August | 34 | 19 | 53 |
| 2022 July | 24 | 36 | 60 |
| 2022 June | 17 | 24 | 41 |
| 2022 May | 27 | 32 | 59 |
| 2022 April | 33 | 33 | 66 |
| 2022 March | 32 | 39 | 71 |
| 2022 February | 27 | 42 | 69 |
| 2022 January | 13 | 22 | 35 |
| 2021 December | 24 | 34 | 58 |
| 2021 November | 37 | 33 | 70 |
| 2021 October | 30 | 47 | 77 |
| 2021 September | 26 | 24 | 50 |
| 2021 August | 23 | 31 | 54 |
| 2021 July | 22 | 25 | 47 |
| 2021 June | 19 | 33 | 52 |
| 2021 May | 29 | 38 | 67 |
| 2021 April | 77 | 77 | 154 |
| 2021 March | 34 | 24 | 58 |
| 2021 February | 26 | 13 | 39 |
| 2021 January | 48 | 28 | 76 |
| 2020 December | 27 | 19 | 46 |
| 2020 November | 23 | 15 | 38 |
| 2020 October | 33 | 22 | 55 |
| 2020 September | 62 | 39 | 101 |
| 2020 August | 70 | 7 | 77 |
| 2020 July | 48 | 16 | 64 |
| 2020 June | 30 | 25 | 55 |
| 2020 May | 14 | 7 | 21 |
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