INSR and renal fibrosis: It is possible that lncRNA Erbb4-IR may mediate Ang II-induced cardiac disease by reducing cardiac Smad7. This is consistent with our previous finding that Erbb4-IR acts as an integrated effector molecular to promote renal fibrosis by targeting Smad7 by directly binding to the 3′ UTR of the Smad7 genomic sequence.21