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Exact(8)
Macrophages (Mφ) polarize to the M1 type in the acute inflammation phase, and the M2 type in the chronic fibrosis phase, which has important implications in the design of Mφ-targeted therapy for IPF.
Only a handful compounds were administered in the fibrosis phase as therapeutic agents.
When normal cells cannot repair the injury completely, MFs will be activated to repair injury and come to the fibrosis phase.
In the single dose BLM model, pulmonary fibrosis develops through sequential events after BLM administration; first in inflammation phase (≤7 days), followed by fibrosis phase (≥7 days) [ 30].
In addition, a recent evaluation of the activated genes after BLM administration has suggested similarities between molecular signatures obtained during the late fibrosis phase and rapidly progressing IPF [ 19].
After tissue is injured, the repair process involves two stages: a regenerative phase, injured tissues are replaced by cells of the same type; and a fibrosis phase, connective tissue replaces the normal tissue.
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Over 70 patients have now received at least one dose of gene therapy in the 'Wave I' gene therapy of cystic fibrosis a Phase IIB trial being conducted at 2 sites in the UK [43].
Based on the apparent importance of the LPA-LPA1 pathway for the development of lung fibrosis, a Phase II clinical trial of an oral LPA1 antagonist for the treatment of IPF has recently been initiated (ClinicalTrials.gov identifier: NCT01766817).
On the other hand, in the fibrosis resolution phase, MMP-2 activity in serum [ 18] and liver tissue [ 19] is high and high serum levels of MMP-9 and MMP-2 were found as early as 6 h after hepatectomy [ 20].
Thus, our findings establish the ECM-sequestered proform as the noncellular source of high MMP-2 activity found in the fibrosis resolution phase supposed earlier [ 18- 20] and Hyp-containing collagen analogs as tools for targeted release of proMMP-2 and proMMP-9 from their extracellular depot and concomitant activation of the enzymes.
Moreover, inhibition of PI3K was proved to prevent the proliferation and differentiation of human lung fibroblasts into myofibroblasts in vitro and the PI3K inhibitors, WO2013117503 and WO2013117504 have been used to treat idiopathic pulmonary fibrosis in Phase I study 32, 33.
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