When investigating the mechanism, it was found that it indirectly influences the expression of TBX4, a mesenchymal transcription factor that drives the accumulation of myofibroblasts and the development of pulmonary fibrosis (147), through interacting with DNA (cyto-sine-5)-methyltransferase 3A (DNMT3A) that methylates TBX4 promoter (148). This evidence concerns the gene TBX4 and pulmonary fibrosis.