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[Abstract] Orthop Surg

Figure 1 Common pathways of pathogenesis: immune dysregulation, epigenomics, the microbiome Immune dysregulation Inflammation is an adaptive response to stressors that involves multiple physiological processes that include the innate and adaptive immune systems

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Furthermore, hypoxia can have proliferative effects on human fibroid cells by inducing the expression of NADPH oxidase 4 (NOX4) through the HIF-1/TGF-3/Smad3/NOX4 signaling pathway, wherein the phosphorylation of Smad3 by TGF-3 under hypoxic conditions leads to cellular proliferation and fibroid growth (Figure 2) [8]