Disorders of lung matrix remodeling
J. Clin. Invest. Harold A. Chapman, et al. 113:148 doi:10.1172/JCI20729 [
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Figure 2Determinants of lung response to breakdown in epithelial barrier function. (
a) Coordinated processes of tissue factor/factor VII complexes initiating thrombin formation and plasminogen activation by urokinase (uPA). Plasmin facilitates initial exudate turnover. Ingrowth of fibroblasts and organization of exudates into a collagenous matrix occurs quickly. (
b) Maintenance of epithelial integrity, resorption of ECMs by AMs, and fibroblast apoptosis favor resolution. (
c) Epithelial cell apoptosis, activation of receptors of the profibrotic cytokines thrombin, leukotrienes, and TGF-β
1, and persistence of the ECM secondary to excess protease inhibitors (PAI-1 and tissue inhibitor of metalloprotease) with accumulation of fibroblast growth factors (IGF, PDGF, CTGF) favors fibrosis.