ACTA1 and Hepatic fibrosis: Hypoxia can trigger the main signal transduction pathway of the EMT process [75]: Copple et al. knocked out the HIF-1α gene in mice and found that hypoxia increases the fibroblast marker molecules such as α-SMA and vimentin in primary mouse liver cells, suggesting that hypoxia stimulates EMT of hepatocytes, thereby promoting liver fibrosis [76].