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Fibrosis is a complex outcome of healing process when connective tissue replaces parenchyma leading to the loss of function and organ failure. It is associated with abnormally high accumulation of myofibroblasts differentiated from cells of mesenchymal origin. They excessively produce extracellular matrix components like collagen and fibronectin. Elimination of myofibroblasts is essential for fibrosis regression. Multipotent mesenchymal stromal cells (MSCs) could play a dual role in the development of fibrosis: some MSCs replenishe a myofibroblast pool promoting the progression of fibrosis, but they also could suppress fibrosis due to the antifibrotic effects of their secretome, including transfer of non-coding RNAs. MicroRNAs (miRNAs) make up the class of non-coding RNAs that control gene expression by gene silencing on transcriptional level and thus can contribute to MSC regulation of myofibroblast differentiation, which makes them promising targets for fibrosis management.