Targeting lipid-fibrotic signaling crosstalk for antifibrotic therapy

Fibrosis is essentially a compromised wound-healing process in which fibroblasts remain engaged for an extended period of time, resulting in an excessive accumulation of extracellular matrix and ultimately leading to organ failure. Although well-known drivers, including transforming growth factor-β, Wnt/β-catenin, nuclear factor kappa-B, and sphingosine-1-phosphate signaling, are well-established, studies reveal that lipid metabolism is crucial for regulating these pathways. Inflammation, oxidative stress, cell energy consumption, and the conversion of cells into scar-forming myofibroblasts are all influenced by lipids, which are no longer only inert building blocks or fuel. Changes in phospholipids, fatty acids, sphingolipids, and cholesterol are examples of dysregulated lipid synthesis, remodeling, and oxidation that produce a metabolic milieu that supports fibrotic signaling and accelerates the course of the disease. This review deciphers the bidirectional crosstalk between fibrotic signaling pathways and how lipids are involved in different fibrotic signaling pathways in different organ systems, enumerating how profibrotic transcriptional programs and metabolic reprogramming are combined by lipid-derived mediators to form feed-forward loops that sustain fibrosis. Unraveling the underpinnings in lipid-fibrosis axis provides testament of lipid signaling and involvement as viable pathways for precision medicine and antifibrotic intervention by revealing new biomarkers and therapeutic targets.