CTGF is a central mediator of tissue remodeling and fibrosis and its inhibition can reverse the process of fibrosis

TLDR

CTGF is a secreted matricellular protein that regulates signaling pathways driving cell adhesion, migration, angiogenesis, myofibroblast activation, and extracellular matrix remodeling, thereby promoting tissue remodeling and fibrosis. Inhibition of CTGF—by siRNA or the monoclonal antibody FG‑3019—has been shown to prevent and reverse fibrosis in liver, cardiac, vascular, and pulmonary models, improving organ function and reducing tissue density.

Abstract

CTGF is a secreted matricellular protein with very complex biology. It has been shown to modulate many signaling pathways leading to cell adhesion and migration, angiogenesis, myofibroblast activation, and extracellular matrix deposition and remodeling, which together lead to tissue remodeling and fibrosis. It has been reported in the literature that inhibition of CTGF expression by siRNA prevents CCl4-induced liver fibrosis and can reverse fibrosis when administered after significant collagen deposition is observed. A monoclonal antibody to CTGF that is currently in clinical development (FG-3019) has demonstrated the ability to reverse vascular stiffening and improve cardiac function in a rat model of diabetic complications. FG-3019 has also exhibited activity in a murine radiation-induced pulmonary fibrosis model. When FG-3019 was administered to mice after a significant radiation-induced increase in lung density could be observed by CT imaging, the density of the lungs was observed to decrease over the period during which the antibody was administered and to remain stable after therapy had ceased. When considered together, these data indicate that inhibition of CTGF can prevent and reverse the process of fibrosis.