Collagen Prolyl 4-Hydroxylase: An Emerging Key Player in Cardiac Fibrosis

Collagen prolyl 4-hydroxylase (C-P4H) is a key enzyme that controls collagen maturation and fibrotic matrix buildup. Cardiac fibrosis is a major pathological basis of many cardiovascular diseases. It is marked by excess collagen deposition and extracellular matrix stiffening, which lead to myocardial stiffness and progression to heart failure. Growing evidence shows that C-P4H and its related subunits are abnormally expressed in several cardiac diseases linked to fibrosis and are closely associated with disease development. C-P4H regulates intracellular procollagen maturation and secretion and thereby indirectly influences extracellular matrix remodeling. Targeting C-P4H has also shown antifibrotic effects in several fibrosis models, which suggests that this enzyme may serve as a potential therapeutic target in cardiac fibrosis. In this review, we briefly summarize the structure and function of C-P4H, discuss its regulatory roles in the development of cardiac fibrosis, and outline the therapeutic prospects of targeting C-P4H.