These signaling targets participate in the formation of multiple signaling pathways, such as the SIRT1-Nrf2-HO-1 pathway, thereby achieving anti-fibrotic effects both in vivo and in vitro through mechanisms such as inhibiting immune-inflammatory responses and oxidative stress, which significantly attenuates PF (229).The latest research indicates that RES can alleviate PF by inhibiting TGF-β-activated kinase 1 (TAK1) (230). This evidence concerns the gene SIRT1 and pemphigus foliaceus.