Gene knockdown experiments further confirmed that the absence of Nox4 inhibits the TGF-β/SMAD signaling pathway and reduces the transcription of fibrosis-related genes, suggesting that the Nox4-ROS-TGF-β axis plays a crucial role in the stromal-epithelial interaction in PCa (27, 28). Here, TGFB1 is linked to posterior cortical atrophy.