Extracellular matrix and endotypes

The extracellular matrix (EMC) is a pivotal regulator of cell and tissue behavior and plays a central role in tissue homeostasis as well as in organ pathologies and system diseases. The extracellular matrix can under pathological conditions alter the remodeling of cell types and have profound effects on cellular and clinical phenotypes. Aberrant ECM remodeling can result in elevated levels of tissue degradation and formation products, yielding unique protein fingerprints reflective of phenotypic changes to cell and tissue. These can reveal distinct disease phenotypes and, potentially, clinically actionable molecular endotypes. With the evolving concept of personalized medicine, there is an increasing demand for improved endotyping of patients to better delineate the underlying molecular causes of a disease and allow for more targeted treatments. This chapter highlights the importance of the ECM in the context of disease and the clinical applicability of ECM-related molecular endotypes.