Asiaticoside had no effect on the expression of Smad2, Smad3, and Smad4 [34], while madecassoside regulated keloid-derived fibroblasts proliferation, migration, F-actin filaments, cytoskeletal protein actin, and the phosphorylation of cofilin via p38 MAPK and PI3K/AKT signaling, but not ERK1/2 and caspase-8 signaling [12]. Here, SMAD4 is linked to keloid.