Decorin the antifibrotic proteoglycan and its progression in therapy

Fibrosis, which underlies numerous chronic diseases, is characterized by excessive extracellular matrix (ECM) accumulation, resulting in disrupted tissue architecture. Decorin, a small leucine-rich proteoglycan synthesized primarily by fibroblasts and myoblasts, has emerged as a potent antifibrotic agent mainly by inhibiting transforming growth factor-β (TGF-β), which is a major driver of fibrosis in various tissues and organs such as the heart, eyes, skin, liver, muscle, etc. Numerous therapeutic applications of decorin showcase its ability to reduce fibrosis and improve tissue function. Advances in treatments utilizing recombinant protein, gene-delivery systems, and biomaterials, such as decorin-loaded hydrogels, have demonstrated decorin's potential to improve localized and systemic fibrosis therapies. This review discusses recent advances in decorin's antifibrotic potential and its therapeutic applications.