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Central to this process is the activation of profibrotic cytokines, such as transforming growth factor-beta (TGF-), as well as the activation of fibroblasts and peritubular myoid cells, which secrete abnormal amounts of collagen types I, III, and IV, along with fibronectin (Xiao et al., 2022)

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PLOS ONE 10, e0129937.CrossRefGoogle ScholarPubMed Larimichthys crocea )

Laboratory testing and appropriate workup may reveal that some cases have no known systemic disease association, either infectious or autoimmune