Endothelial to mesenchymal transition: a novel pathological feature of pulmonary fibrosis

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I read with great interest the recent original research article by Wu et al. [1] published in the prestigious European Respiratory Journal (ERJ), which reported on endothelial cell-like myofibroblasts and their role in pulmonary fibrosis using mouse models. I highly commend this work and the focus on endothelial cells in this decidedly fibrotic condition. To further enhance discussion, and to elaborate on the mechanisms involved and contribution of endothelial cells to pulmonary fibrosis, I wish to bring forth some novel insights from our recent work published in ERJ Open Research [2, 3] on idiopathic pulmonary fibrosis (IPF). In these human tissue-based clinical studies, we reported vascular remodelling, extracellular matrix changes and the role of endothelial to mesenchymal transition (EndMT) in driving these pathologies and contribution to fibrosis. These are topical clinical studies on the role of endothelial cells and the process of EndMT in tissue from patients with IPF.