IGF1 and fibrosis: As illustrated in Fig. 8A (Add PPP to CD-NPs-induced passage 40 cells for 24 h) and B, the amounts of p-Akt(Ser473)/Akt, p-GSK3β(Ser9)/GSK3β were increased in the CD-NPs-induced pre-fibrosis model in vitro and in vivo compared with amounts in the control group; this effect was inhibited by PPP, indicating that CD-NPs can induce IGF1/IGF1R signaling-mediated PF through AKT/GSK3β signaling.