As TGF-β is likely to be crucial to maintain the immune tolerance state and T-reg generation/function essential to the parasite, E. multilocularis could be responsible for the paradoxical decrease of Smad7 in the periparasitic granuloma and nearby liver; this might be one of the mechanisms for the early induction of immune tolerance and for the progression from chronic hepatic injury to hepatic fibrosis during E. multilocularis infection. Here, SMAD7 is linked to Hepatic fibrosis.