Fibromodulin (FMOD) is one of the small leucine-rich proteoglycans. A search of the literature did not reveal any paper that specifically reviews the potential clinical applications of FMOD in the management of human diseases. First, the structure and physiological functions of FMOD were reviewed. Then its potential clinical applications in various diseases including diseases of the skin, tendons, joints, intervertebral discs, blood vessels, teeth, uterus, bone and kidney were reviewed. FMOD is able to switch the adult response to skin wounding to the desired fetal response of scarless healing. Lowered levels of FMOD would be desirable in the management of tendinopathy, uterine fibroids, tumors resistant to radiotherapy, glioblastomas, small-cell lung cancer, and primary liver/lung fibrosis. In contrast, increased levels of FMOD would be desirable in the management of acute tendon injuries, osteoarthritis, rheumatoid arthritis, temporo-mandibular disease, joint laxity, intervertebral disc disease, neo-intimal hyperplasia of vein grafts, teeth caries, periodontal disease, endometrial atrophy, osteoporosis and diabetic nephropathy. Furthermore, FMOD may be used as a prognostic marker of cerebrovascular events in patients undergoing carotid endarterectomy and a marker for prostatic cancer. Finally, the use of FMOD in the treatment of symptomatic endometrial atrophy should be explored in women who are unable to use the standard estrogen management for endometrial atrophy. The review concluded that clinical trials in humans should be initiated to investigate the potential therapeutic effects of FMOD.
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