Figure 4. The general mechanism of CyPA-mediated cardiac fibrosis and hypertrophy.

CyPA promotes cardiac fibrosis activation and proliferation, which is mediated by cell surface EMMPRIN. CyPA activates certain signaling pathways and induces oxidative stress, and inflammatory cytokines, resulting in MMPs activation. ROS promotes the release of CyPA, which interacts with EMMPRIN again through autocrine mechanisms in cardiac fibroblasts and paracrine mechanisms in cardiomyocytes.