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3.2 Role of TGF- in radiation skin fibrosis TGF- is a cytokine intricately involved in the fibrotic process across various organs and tissues ( 3.2.1 TGF- Signaling and cellular mechanisms in radiation-induced fibrosis TGF- exerts its effects through the activation and proliferation of fibroblasts, leading to ECM accumulation ( TGF- expression is dose-dependent on radiation exposure, binding to its receptors to form a trimeric complex which can lead to tissue fibrosis ( Figure 2 )

[2] Physiological Bases for the Superiority of Apolipoprotein B Over LowDensity Lipoprotein Cholesterol and NonHighDensity Lipoprotein Cholesterol as a Marker of Cardiovascular Risk | Journal of the American Heart Association

This is metabolically significant because visceral adipose tissue is strongly associated with metabolic dysfunction, insulin resistance, cardiovascular disease risk, and systemic inflammation