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346348 The net result of prolonged hypoxia is that a vicious pathological cycle is initiated in which fibroblast and inflammatory cell activation combine with apoptosis, endothelial proliferation, and epithelial-mesenchymal transition to cause tubulointerstitial fibrosis

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doi: 10.1007/s00018-011-0905-1

Uncertain Mechanisms Although numerous signalling pathways have been proposed, researchers have not identified one definitive mechanism explaining all observed effects