Fig. 2.1
Alveolar epithelial cells are thought to be the initial lesion of lung injury caused by environmental factors, such as smoking, inhalational agents, drugs, oxygen radicals, toxins, and viruses, and intrinsic factors such as genetics and aging. Repeated epithelial injury leads to apoptosis, necrosis, and/or senescence. Surfactant gene mutations induce ER stress response in epithelial cells, and telomere shortening induces epithelial cell apoptosis and senescence. The failure of tissue repair due to impaired homeostasis and deregulated immunological mechanisms leads to disordered epithelial-mesenchymal interactions and finally results in pulmonary fibrosis
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