Fibroproliferative disorders such as idiopathic pulmonary fibrosis and systemic sclerosis have no effective therapies and result in significant morbidity and mortality due to progressive organ fibrosis. We examined the effect of peptides derived from endostatin on existing fibrosis and fibrosis triggered by two potent mediators, transforming growth factor–β (TGF-β) and bleomycin, in human and mouse tissues in vitro, ex vivo, and in vivo. We identified one peptide, E4, with potent antifibrotic activity. E4 prevented TGF-β–induced dermal fibrosis in vivo in a mouse model, ex vivo in human skin, and in bleomycin-induced dermal and pulmonary fibrosis in vivo, demonstrating that E4 exerts potent antifibrotic effects. In addition, E4 significantly reduced existing fibrosis in these preclinical models. E4 amelioration of fibrosis was accompanied by reduced cell apoptosis and lower levels of lysyl oxidase, an enzyme that cross-links collagen, and Egr-1 (early growth response gene–1), a transcription factor that mediates the effects of several fibrotic triggers. Our findings identify E4 as a peptide with potent antifibrotic activity and a possible therapeutic agent for organ fibrosis.

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RECTAL prolapse is not uncommon but prolapse or inversion of the bladder has only lately been reported in adults. The bladder is normally retained in situ by its strong basal attachments and the urachal attachments to the umbilicus. In those cases in which inversion has been reported, there has always been some predisposing lesion such as vesico-vaginal fistula or ligamentous laxity in pregnancy. The patient reported here had never had a full-term pregnancy, but she had probably had local tissue damage caused by previous lymphogranuloma venereum infection, and she also had marked utero-genital prolapse.Case Report.-The patient was a 50-year-old Mugandalady, who had reached the menopause 5 years previously.