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Macrophage-to-myofibroblast transition drives fibrosis across kidney, heart, lung, liver, and retinaMacrophages May Turn Into Scar-Forming Cells In Organs

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Key Takeaway
Recognize MMT as a cross-organ fibrogenesis mechanism, but clinical targeting remains unproven.

This systematic review examines the role of macrophage-to-myofibroblast transition (MMT) in fibrogenesis across multiple organ systems. The authors synthesize evidence that macrophages can directly differentiate into extracellular matrix-producing myofibroblasts, a process termed MMT, and that this transition participates in fibrogenesis.

The review reports that MMT has been validated in multiple organs, including the kidney, heart, lung, liver, and retina. This cross-organ validation suggests MMT may represent a shared cellular mechanism contributing to fibrosis in diverse disease contexts.

The review does not report a study population, sample size, comparator, primary outcome, follow-up duration, effect sizes, p-values, or confidence intervals. Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, are not reported. Limitations of the included evidence are not reported, and funding or conflicts of interest are not reported.

Practice relevance is not reported. Because the review provides no quantitative synthesis, no safety data, and no assessment of evidence certainty, its findings should be interpreted as hypothesis-generating. MMT may be a biologically plausible target across fibrotic diseases, but the absence of pooled effect estimates and clinical outcome data precludes any recommendation for clinical practice or therapeutic targeting at this time.

How this fits prior evidence

This systematic review extends prior preclinical coverage of fibrosis mechanisms, including Astragaloside IV reducing renal fibrosis markers in animal models, by proposing MMT as a cross-organ process validated in kidney, heart, lung, liver, and retina. Unlike the exosomal miRNA and Bangga preclinical syntheses, which focus on biomarkers or multi-activity extracts, this review centers on a cellular transition mechanism. It does not confirm or contrast with the lidocaine-esketamine or ultrasound findings, which address perioperative pain and physical therapy decision-making, respectively. No quantitative effect sizes are provided to compare with prior evidence.

A new review brings together evidence that a type of immune cell called a macrophage can change into a myofibroblast, a cell that makes scar tissue. This process is called macrophage-to-myofibroblast transition, or MMT. The review reports that MMT has been seen in several organs, including the kidney, heart, lung, liver, and retina. This matters because scar tissue, also called fibrosis, can damage these organs over time.

The review is a summary of existing research, not a new experiment. It does not report how many people were studied, how long they were followed, or what treatments were tested. No side effects or safety concerns are described. The review also does not say whether MMT directly causes fibrosis or is simply a marker of it. That distinction is important and remains unclear.

Because the evidence is early and comes from a broad review, readers should not take this as proof that blocking MMT will treat or prevent disease. It is a promising area of research, but much more work is needed before any new treatment could be developed. For now, this finding helps scientists understand how fibrosis might happen, not how to stop it in patients.

What this means for you:
Early research suggests immune cells may turn into scar-forming cells in several organs, but more study is needed.

Common questions

What is macrophage-to-myofibroblast transition (MMT)?

MMT is a process where a macrophage, a type of immune cell, changes into a myofibroblast, a cell that produces scar tissue. The review reports this has been seen in the kidney, heart, lung, liver, and retina. It is one way scientists think fibrosis may develop, but the exact role is still being studied.

Which organs are affected by MMT?

The review says MMT has been validated in multiple organs, including the kidney, heart, lung, liver, and retina. These are organs where fibrosis, or scarring, can cause serious problems. However, the review does not say how common MMT is or how much it contributes to disease in each organ.

Does this research mean there is a new treatment for fibrosis?

No. This is a review of existing evidence, not a clinical trial. It does not test any treatment or report patient outcomes. The finding helps explain a possible mechanism of fibrosis, but no new therapy is available based on this work. Any treatment decisions should be discussed with a doctor.

Is MMT proven to cause fibrosis?

The review does not establish cause and effect. It reports that MMT occurs and may participate in fibrogenesis, but it does not show that MMT directly causes fibrosis. More research is needed to understand whether targeting MMT could help prevent or treat scarring in people.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
Fibrosis is a pathological process primarily characterized by excessive deposition of extracellular matrix (ECM), which leads to disruption of tissue architecture and progressive loss of organ function, serving as a key pathological basis for various chronic diseases. Recent studies have revealed that, in addition to conventional sources, macrophages can directly differentiate into ECM-producing myofibroblasts through a process termed macrophage-to-myofibroblast transition (MMT), thereby actively participating in fibrogenesis. The concept of MMT was initially proposed in the context of renal fibrosis and has since been validated in multiple organs, including the kidney, heart, lung, liver, and retina. This review aims to summarize the role of MMT in fibrotic diseases and to elucidate the mechanism underlying MMT and fibrosis progression. Unlike prior reviews that predominantly focus on MMT within individual organs or separately delineate their molecular pathways, this review adopts a cross-organ perspective to systematically identify conserved mechanisms, tissue-specific regulatory networks, and translational challenges of MMT across fibrotic diseases.
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