Decreased h-TERT expression levels may represent decreased h-TERT mRNA transcription due to downregulation by a variety of factors, such as p53, TGF-β, Wilms tumor-1 (Wt-1) and murine double minute 2 (Mdm2) (27), which have been implicated in the pathogenesis of IPF. Here, MDM2 is linked to idiopathic pulmonary fibrosis.