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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 )