Lysyl oxidase (LOX) family members: rationale and their potential as therapeutic targets for liver fibrosis
Abstract
The cross-linking of structural extracellular matrix (ECM) components, especially fibrillar collagens and elastin, is strongly implicated in fibrosis progression and resistance to fibrosis reversal. Lysyl oxidase family members (LOX and LOXL1 [lysyl oxidase-like 1], LOXL2 [lysyl oxidase-like 2], LOXL3 [lysyl oxidase-like 3], and LOXL4 [lysyl oxidase like 4]) are extracellular copper-dependent enzymes that play a key role in ECM cross-linking, but have also other intracellular functions relevant to fibrosis and carcinogenesis. Although the expression of most LOX family members is elevated in experimental liver fibrosis of diverse etiologies, their individual contribution to fibrosis is incompletely understood. Inhibition of the LOX family as a whole and of LOX, LOXL1, and LOXL2 specifically has been shown to suppress fibrosis progression and accelerate its reversal in rodent models of cardiac, renal, pulmonary, and liver fibrosis. Recent disappointing clinical trials with a monoclonal antibody against LOXL2 (simtuzumab) in patients with pulmonary and liver fibrosis dampened enthusiasm for LOX family member inhibition. However, this unexpected negative outcome may be related to the inefficient antibody, rather than to LOXL2, not qualifying as a relevant antifibrotic target. Moreover, LOX family members other than LOXL2 may prove to be attractive therapeutic targets. In this review, we summarize the structural hallmarks, expression patterns, covalent cross-linking activities, and modes of regulation of LOX family members and discuss the clinical potential of their inhibition to treat fibrosis in general and liver fibrosis in particular.
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Simtuzumab is a humanised monoclonal antibody against LOXL2.
“Simtuzumab is a humanised monoclonal antibody against lysyl oxidase-like 2 (LOXL2), which has raised much hope for treatment of fibrosis in both NASH and PSC, since LOXL2 contributes to fibrogenesis by cross-linkage of collagen and regulates bile duct permeability.225 226”
From Novel therapeutic targets for cholestatic and fatty liver disease (2022) · cites this paper as [225]
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- Authors
- Chen, W., Yang, A., Jia, J., Popov, Y. V., Schuppan, D., & You, H.
- Affiliations
- Capital Medical University (CN)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Schuppan, Detlef
- You, Hong
- Venue
- Hepatology
- Published
- 2020-08
- Volume
- 72
- Issue
- 2
- Pages
- 729-741
- ISSN
- 0270-9139 (ISSN-L)
- 1527-3350
- OpenAlex
- W3012463633
- Cited by
- 284
- References
- 69
- Citations by year
- 2026: 49 · 2025: 56 · 2024: 73 · 2023: 39 · 2022: 31 · 2021: 29 · 2020: 6
- FWCI
- 3.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Microbial metabolism and enzyme function
- Keywords
- lysyl oxidase, liver fibrosis, extracellular matrix cross-linking, LOXL2, LOXL1, LOXL3, LOXL4, copper enzymes, fibrosis reversal, collagen cross-linking, elastin
- MeSH terms
- Amino Acid Oxidoreductases, Animals, Humans, Liver Cirrhosis, Protein-Lysine 6-Oxidase
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