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When water remains still, biocide levels drop, and biofilms form on interior surfaces

TGF- triggers the Wnt/-catenin pathway by inducing Wnt ligands, leading to fibroblast activation and proliferation and its transformation to myofibroblast, the primary cell responsible for excessive ECM production, including collagen and fibronectin ( 3.3 Epigenetic regulators of fibrotic gene expression 3.3.1 MicroRNA MicroRNAs (miRNAs) play a pivotal role in the epigenetic regulation of radiation-induced skin fibrosis, acting as key post-transcriptional regulators by binding to the 3 untranslated regions (3 UTRs) of target mRNAs ( 3.3.2 DNA methylation DNA methylation involves the addition of methyl groups to cytosine bases in DNA and significantly influences gene expression in radiation-induced skin fibrosis

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IIV, interindividual variability

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