Extracellular Matrix Remodeling in Human Disease

The extracellular matrix (ECM) is a meshwork of proteins and carbohydrates that supports many biological structures and processes, from tissue development and elasticity to preserve the structures of entire organs. In each organ, the composition of the ECM is distinct. It is a remarkably active three-dimensional structure that is continuously undergoing remodeling to regulate tissue homeostasis. This review aims to explain the role of ECM proteins in the remodeling process in different types of disease. The hardening of the ECM (desmoplasia), as well as its manipulation, induction, and impairment in regulation of its composition can play a role in several diseases, examples of which are chronic obstructive pulmonary disease, pancreatic ductal adenocarcinoma, spinal cord injury, progression and metastasis of breast cancer, and neurodegenerative condition in the brain such as Alzheimer's disease. Remodeling is also associated with diet-induced insulin resistance in many metabolic tissues. A greater comprehension of the way in which the ECM regulates organ structure and function and of how ECM remodeling affects the development of diseases may lead to the improvement and discovery of new treatments.