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TGF-1 is a powerful pro-fibrotic mediator that promotes epithelial cell apoptosis, epithelial-mesenchymal transition, and the production of other profibrotic mediators, such as vascular endothelial growth factor (VEGF), connective tissue growth factor (CTGF), and other pro-angiogenic mediators, forming a positive feedback loop (Grimminger et al., 2015)