Conversely, the GHSR/Foxo1 axis promotes TGF-β1 secretion in macrophages via PKA-mediated phosphorylation of Foxo1 at S273, activating hepatic stellate cells and exacerbating inflammatory infiltration, thus aggravating carbon tetrachloride-induced liver fibrosis (174). This evidence concerns the gene FOXO1 and Hepatic fibrosis.