“…This process usually occurs over many months or years and causes organ damage or death. The progression of fibrosis is considered to result from maladaptive repair processes caused by profibrotic factors such as TGF-β, CTGF, AngII, PDGF, IFN-γ, and HMGB1, and the profibrotic factors induce myofibroblast differentiation from tissue-resident fibroblasts and bone marrow-derived mesenchymal stem cells (MSCs), epithelial-to-mesenchymal transition (EMT) and EndoMT [ 55 , 70 , 71 , 109 , 110 , 111 ]. In addition, PGF 2α is elevated in SSc patients and is associated with fibrosis progression independently of TGF-β [ 112 , 113 ].…”