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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 )

Wang M , Fayad L, Hagemeister F, Neelapu S, Samuels B, Samaniego F, Pro B, Yi Q, Bell N, Byrne C, Weaver P, Hartig K, Knight R, Zeldis J, Kwak L, Romaguera J

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As a result, cysteinyldopa synthesis is induced, leading to increased production of pheomelanin, which is yellow-red