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Pathogenic expansion: fibroblast proliferation fuels fibrosis
Cody A. Schott, Elizabeth F. Redente
Cody A. Schott, Elizabeth F. Redente
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Commentary

Pathogenic expansion: fibroblast proliferation fuels fibrosis

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Abstract

Pulmonary fibrosis, an unrelenting disease of lung scarring, has been associated with the expansion of a profibrotic fibroblast population and extensive extracellular matrix deposition. In this issue, Molina and colleagues provide foundational mechanistic evidence that fibroblast proliferation itself is a critical driver of fibrosis. Using lineage tracing in preclinical fibrosis models, the authors showed that naive Scube2+ alveolar fibroblasts underwent a profibrotic phenotypic switch prior to proliferating within areas of fibrotic remodeling. Induction of apoptosis via Esco2 deletion or directly preventing proliferation via Ect2 deletion in these fibroblasts attenuated fibrosis. Complementary analyses on explanted human lung tissue confirmed translational relevance, collectively providing compelling evidence for the importance of fibroblast proliferation in fibrotic disease.

Authors

Cody A. Schott, Elizabeth F. Redente

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Figure 1

Schematic of fibroblast response to injury during fibrosis development.

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Schematic of fibroblast response to injury during fibrosis development.
...
Molina et al. demonstrated that alveolar fibroblasts, defined by Scube2 expression, first undergo profibrotic differentiation into a CD9+, Cthrc1+ population. Differentiation into this population was followed by clonal proliferative expansion. Genetic deletion of either Esco2, which induces apoptosis in the profibrotic population, or Ect2, which inhibits clonal proliferation of the population, reduced proliferating fibroblasts and fibrosis development (3).

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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