Neff · Cellular signalling 2021 · narrative review · n=?

Cross your heart? Collagen cross-links in cardiac health and disease.

Cited 77 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of mechanisms without systematic methodology or original empirical data

PubMed 33347984 · doi:10.1016/j.cellsig.2020.109889 · record verified 2026-08-29

What was done

Narrative review describing extracellular matrix remodeling, fibrotic collagen accumulation, and cellular mechanisms of collagen cross-linking across cardiac insults (infarction, pressure overload, dilated cardiomyopathies) and aging. The review focuses on three cross-linking pathways: lysyl oxidases, transglutaminases, and non-enzymatic advanced glycation end products.

What was found

No quantitative data or statistics are reported in the abstract. The abstract qualitatively notes that myocardial fibrillar collagen content and cross-linking influence tissue properties, including insolubility and stiffness, contributing to cardiac dysfunction.

Why it matters

Understanding the distinct enzymatic and non-enzymatic pathways regulating collagen cross-linking may identify therapeutic targets to prevent or reverse pathological cardiac fibrosis and tissue stiffening.

Limits

This is a narrative review with no primary empirical data or systematic search protocol reported. The abstract provides no quantitative metrics, effect sizes, sample sizes, or clinical comparative outcomes.

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