SMAD2 and Hepatic fibrosis: For example, liver fibrosis can be influenced by serum exosome-derived miR-193a-5p and miR-381-3p through modulation of the AMPK/TGF-β/Smad2/3 signaling pathway,11 while lung cancer patients with significantly reduced levels of miRNA-508-3p tend to have poorer survival rates.12