Fig. 7

The diagram of mechanism underlying HE4 regulation in COPD. Cigarette smoke promotes HE4 expression and secretion in bronchial epithelial cells partly through oxidative stress, and then mediated IL-6 production via the phosphorylation of NFκB-p65 to participate in airway inflammation. The elevated HE4 release from bronchial epithelial cells facilitates fibroblast to myofibroblast differentiation and fibroblastic proliferation to aggravate airway remodeling. HE4, human epididymis protein 4; ROS, reactive oxygen species; IL-6, interleukin-6; COPD, chronic obstructive pulmonary disease