Immunomodulatory Role of the Extracellular Matrix Within the Liver Disease Microenvironment
Open accessAbstract
Chronic liver disease when accompanied by underlying fibrosis, is characterised by an accumulation of extracellular matrix (ECM) proteins and chronic inflammation. Although traditionally considered as a passive and largely architectural structure, the ECM is now being recognised as a source of potent DAMPs with immune-active peptides and domains. In parallel, the ECM anchors a range of cytokines, chemokines and growth factors, all of which are capable of modulating the immune responses. A growing body of evidence shows that ECM proteins themselves are capable of interacting both directly, via a wide range of receptors including integrins and TLRs, and indirectly with immune cells. ECM deposition and remodelling during fibrosis can result in release or formation of ECM-DAMPs, which can drive immune cellular infiltration and sterile inflammation. Both the ECM and immune response are interlinked and integral in driving fibrosis, although their precise interactions in the context of chronic liver disease are poorly understood. This review aims to shed light on the ECM-immune interactions underlying liver disease, in particular fibrosis of different aetiologies, by describing the main ECM intact proteins and ECM-DAMPs with known immune regulatory activity. We also discuss how tissue engineering could provide new opportunities to explore ECM-immune cell interactions in bioreactor-based dynamic 3D models containing intact decellularized ECM scaffolds. A better understanding of these interactions would aid in the identification of new antifibrotic and immunomodulatory targets for treatment and biomarkers in liver disease.
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LMWHAs are released during ECM damage or degradation, act as DAMPs and drive inflammatory responses such as enhancing immune cell chemotaxis, DC maturation, and M1 polarization of macrophages via CD44 and TLRs.
“In contrast to HMWHAs, low molecular weight hyaluronic acids (LMWHAs) are released during ECM damage or degradation, which act as DAMPs and drive inflammatory responses such as enhancing immune cells chemotaxis, DCs maturation, and M1 polarization of macrophages via the same receptors (CD44 and TLRs) [63, 100].”
From Immunogenicity of decellularized extracellular matrix scaffolds: a bottleneck in tissue engineering and regenerative medicine (2023) · cites this paper as [100]
The “Low Molecular Weight-Hyaluronic Acid” section (page unavailable) says HA fragments arise during injury, identifies LMW-HA as an ECM-DAMP, and describes pro-inflammatory responses through TLR2, TLR4 and CD44. It reports antigen-presenting-cell maturation and cell migration, but does not specifically establish immune-cell chemotaxis or M1 macrophage polarization. (LLM, conf=0.88)
Experimental — accuracy not yet measuredActivation of TLRs and CD44 receptors by HMWHAs accompanies a decrease in DC maturation and promotion in the polarization of macrophages toward M2 phenotype besides differentiation of T cells into regulatory phenotype and induction of apoptosis in activated T cells.
“Activation of these receptors accompanies a decrease in DC maturation and promotion in the polarization of macrophages toward M2 phenotype besides differentiation of T cells into regulatory phenotype and induction of apoptosis in activated T cells.”
From Immunogenicity of decellularized extracellular matrix scaffolds: a bottleneck in tissue engineering and regenerative medicine (2023) · cites this paper as [100]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredImmunomodulatory traits of dECM scaffolds are largely attributed to the ability of their collagens to trigger LAIR-1 of immune cells and consequently downregulation of immune cell activity.
“Immunomodulatory traits of dECM scaffolds are largely attributed to the ability of their collagens to trigger leukocyte-associated immunoglobulin-like receptors-1 (LAIR-1) of immune cells and consequently downregulation of immune cell activity [100].”
From Immunogenicity of decellularized extracellular matrix scaffolds: a bottleneck in tissue engineering and regenerative medicine (2023) · cites this paper as [100]
The “Immunomodulatory Properties of the ECM” and “Collagen” sections say collagen binds LAIR-1 on immune cells and that this interaction suppresses immune activity (page unavailable). The Discussion addresses decellularized ECM scaffolds, but does not say their immunomodulatory traits are largely due to collagen–LAIR-1 signaling; it also describes other ECM immunomodulatory mechanisms. (LLM, conf=0.87)
Experimental — accuracy not yet measuredHMWHAs exert anti-inflammatory effects by impeding antigen-antibody interaction and triggering TLRs and CD44 receptors of innate and adaptive immune cells.
“In another example, high molecular weight hyaluronic acids (HMWHAs), well-known GAGs of dECM, exert anti-inflammatory effects by impeding antigen-antibody interaction and triggering toll-like receptors (TLRs), a subgroup of PRRs, and CD44 receptors of innate and adaptive immune cells.”
From Immunogenicity of decellularized extracellular matrix scaffolds: a bottleneck in tissue engineering and regenerative medicine (2023) · cites this paper as [100]
The High Molecular Weight-Hyaluronic Acid section describes HMW-HA as anti-inflammatory, says it limits antigen–antibody interactions, and reports immune-regulatory effects through CD44. It says HMW-HA inhibits TLR2 signaling, however, rather than triggering TLRs; the Low Molecular Weight-Hyaluronic Acid section attributes TLR2 and TLR4 activation to LMW-HA. (LLM, conf=0.90)
Experimental — accuracy not yet measuredECM is a reservoir for cryptic particles that activate or suppress inflammation and orchestrates innate and adaptive immune responses.
“ECM is a reservoir for the cryptic particles that activate or suppress inflammation and orchestrates innate and adaptive immune responses [100, 101].”
From Immunogenicity of decellularized extracellular matrix scaffolds: a bottleneck in tissue engineering and regenerative medicine (2023) · cites this paper as [100]
Harsh decellularization procedures may unveil certain cryptic helical and terminal antigenic sites of collagen, prompting initiation of antibody production against the ECM.
“For instance, harsh decellularization procedures may unveil certain cryptic helical and terminal antigenic sites of collagen, prompting the initiation of antibody production against the ECM [73].”
From Liver tissue engineering using decellularized scaffolds: Current progress, challenges, and opportunities (2024) · cites this paper as [73]
The Discussion (page unavailable) describes how decellularization can alter ECM composition and states that removing cellular content reduces the risk of negative immune responses. The Collagen section (page unavailable) describes collagen’s interactions with immune-cell receptors. Neither section addresses whether harsh decellularization exposes cryptic collagen antigenic sites or initiates antibody production; searches for those terms found no supporting passage. (LLM, conf=0.73)
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- Authors
- McQuitty, C. E., Williams, R., Chokshi, S., & Urbani, L.
- Affiliations
- King's College London (GB)
- Corresponding author
- Urbani, Luca
- Venue
- Frontiers in Immunology
- Publisher
- Frontiers Media SA
- Published
- 2020-11-11
- Volume
- 11
- Pages
- 574276-574276
- ISSN
- 1664-3224 (ISSN-L)
- PMC
- PMC7686550
- OpenAlex
- W3098031338
- Cited by
- 146
- References
- 446
- Citations by year
- 2026: 23 · 2025: 22 · 2024: 34 · 2023: 31 · 2022: 19 · 2021: 17
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Immunology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Surgery › Tissue Engineering and Regenerative Medicine
- Keywords
- extracellular matrix, chronic liver disease, liver fibrosis, damage-associated molecular patterns, sterile inflammation, integrins, TLRs, immune cell infiltration, tissue engineering, biomarkers
- MeSH terms
- Anti-Inflammatory Agents, Extracellular Matrix, Humans, Inflammation, Liver, Liver Cirrhosis, Liver Diseases, Cytokines, Extracellular Matrix Proteins, Immunomodulation
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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