Figure 2

Mesenchymal cell survival in the progression of airway fibrosis following injury by environmental factors. Airway injury occurs after the inhalation of a variety of inhaled metals, fibers, particles or nanoparticles. After initial injury by particle insult, the airway epithelium produces chemokines that attract macrophages. Both macrophages and the epithelium produce cytokines, chemokines and growth factors that stimulate mesenchymal cell (fibroblast and myofibroblast) accumulation within days. Airway smooth muscle also undergoes hyperplasia and hypertrophy after particle injury. Mesenchymal cells undergo growth arrest and apoptosis, but leave deposited extracellular matrix (e.g., collagen) that defines the airway fibrotic lesion.