ROMs are involved in the three main pathological processes of SSc: inflammation (macrophage polarization and NRLP3 inflammasome activation), autoimmunity (autoantibody induction, differentiation, and activation of B and T lymphocytes), and fibrosis (activation of fibroblasts, transforming growth factor-β (TGF-β), and matrix metalloproteinases). Here, TGFB1 is linked to systemic sclerosis.