In keloids, several upstream modulators of the TGF-β1/Smad pathway, including activating transcription factor 3 (ATF3), CR6-interacting factor 1 (Crif1), NLR family CARD domain containing 5 (NLRC5), and nuclear receptor subfamily 3, group C, member 1 (NR3C1), are overexpressed in keloid fibroblasts, enhancing the TGF-β1/Smad pathway [68,69,70]. Here, ATF3 is linked to keloid.