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Insights from human genetic studies of lung and organ fibrosis
Christine Kim Garcia
Christine Kim Garcia
Published January 2, 2018
Citation Information: J Clin Invest. 2018;128(1):36-44. https://doi.org/10.1172/JCI93556.
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Insights from human genetic studies of lung and organ fibrosis

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Abstract

Genetic investigations of fibrotic diseases, including those of late onset, often yield unanticipated insights into disease pathogenesis. This Review focuses on pathways underlying lung fibrosis that are generalizable to other organs. Herein, we discuss genetic variants subdivided into those that shorten telomeres, activate the DNA damage response, change resident protein expression or function, or affect organelle activity. Genetic studies provide a window into the downstream cascade of maladaptive responses and pathways that lead to tissue fibrosis. In addition, these studies reveal interactions between genetic variants, environmental factors, and age that influence the phenotypic spectrum of disease. The discovery of forces counterbalancing inherited risk alleles identifies potential therapeutic targets, thus providing hope for future prevention or reversal of fibrosis.

Authors

Christine Kim Garcia

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Figure 3

Distribution of phenotypic variation implicates multiple different alleles and roles of environment and aging.

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Distribution of phenotypic variation implicates multiple different allel...
Extreme phenotypes, such as those that are seen in patients with Mendelian disorders, occur with an earlier onset and demonstrate more rapid progression. Individuals with familial aggregation of fibrosis phenotypes show not only enrichment of pathogenic rare variants, but also effects from common variants. Environmental factors influence the spectrum of phenotypes and include direct physical or cellular injury, infection, inflammation, and nutritional effects. Aging likely influences fibrosis through genomic-independent and -dependent mechanisms. Protective genetic variants are uncommonly identified but provide information regarding forces that balance disease susceptibility factors.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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