In idiopathic pulmonary fibrosis patients, NUDT21 is down-regulated, and NUDT21 knockdown in lung fibroblast cells results in a significant shift to proximal PAS usage with enrichment of transforming growth factor-beta (TGF-β), Wnt, and hypoxia inducible factor 1 subunit alpha (HIF1A) signalling pathways [195]. Here, HIF1A is linked to pulmonary fibrosis.