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Review
. 2025 Jun 10;3(1):25.
doi: 10.1038/s44324-025-00063-4.

ECM formation and degradation during fibrosis, repair, and regeneration

Alejandro E Mayorca-Guiliani  1 , Diana Julie Leeming  2 , Kim Henriksen  2 , Joachim Høg Mortensen  2 , Signe Holm Nielsen  2 , Quentin M Anstee  3   4 , Arun J Sanyal  5 , Morten A Karsdal  2 , Detlef Schuppan  6   7
Affiliations
Review

ECM formation and degradation during fibrosis, repair, and regeneration

Alejandro E Mayorca-Guiliani et al. NPJ Metab Health Dis. .

Abstract

Imperfect attempts at organ repair after repeated injury result in aberrant formation of extracellular matrix (ECM) and loss of tissue structure. This abnormal ECM goes from being a consequence of cellular dysregulation to become the backbone of a persistently fibrotic cell niche that compromises organic function and ultimately drives systemic disease. Here, we review our current understanding of the structure of the ECM, the mechanisms behind organ-specific fibrosis, resolution, healing and regeneration, as well as the development of anti-fibrotic strategies. We also discuss the design of biomarkers to investigate fibrosis pathophysiology, track fibrosis progression, systemic damage, and fibrosis resolution.

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Conflict of interest statement

Competing interests: A.E.M.-G., D.J.L., K.H., J.H.M., and M.A.K. are employees of Nordic Bioscience A/S. D.J.L., K.H., J.H.M., S.H.N., and M.A.K. are Nordic Bioscience A/S stockholders. A.J.S.: has stock options in Durect, Inversago, Tiziana, Rivus, Exhalenz, Genfit. He has served as a consultant to Intercept, Gilead, Takeda, Meck, Eli Lilly, Novo Nordisk, Astra Zeneca, Boehringer Ingelheim, Alnylam, Regeneron, Histoindex, Path AI, Pfizer, 89Bio, Altimmune, Northsea, Akero, Madrigal, Salix, Myovant, Poxel, Surrozen, Hanmi, Aligos, Promed, Zydus. His institution has received grants from Intercept, Novo Nordisk, Eli Lilly, Boehringer Ingelheim, Echosens, Hanmi, Madrigal, Gilead, Salix, Meck, Takeda. He receives royalties from Elsevier and Wolter Kluwers. D.S.: is CMO, co-CEO/CSO for ImmuneNTech, and consults for Falk Pharma, Takeda, Boehringer-Ingelheim, Resalis, Immunic, Sanofi, Northsea Bioscirences.

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References

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