“…There is ample experimental evidence to support the role of the ALK5/Smad3 axis in the pathogenesis of fibrosis in many different tissues. In animal models, pharmacologic inhibition of ALK5 attenuated fibrotic remodeling of the lung ( Bonniaud et al, 2005 ), liver ( de Gouville et al, 2005 ), kidney ( Moon et al, 2006 ), heart ( Engebretsen et al, 2014 ), intestine ( Medina et al, 2011 ), vasculature ( Fu et al, 2008 ), and bone marrow ( Yue et al, 2017 ). In fibroblasts, the potent fibrogenic actions of TGF-β/ALK5 signaling are predominantly mediated through activation of Smad3 ( Zhao et al, 2002 ; Flanders et al, 2002 ; Sato et al, 2003 ; Bujak et al, 2007 ; Dobaczewski et al, 2010 ; Khalil et al, 2017 ).…”