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Metformin, an AMPK activator, inhibits TGF-β1-induced myofibroblast differentiation by promoting AMPK expression, leading to myofibroblast deactivation and apoptosis, reduction in the expression of type I collagen, fibronectin (FN), and α-SMA in fibroblasts, and downregulation of ECM protein levels, thereby slowing or reversing PF (Rangarajan et al., 2018)

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Further research is needed to evaluate the utility of these biomarkers in clinical practice