IGFBP4 and fibrosis: Overexpression of IGFBP4 partly reversed the profibrotic effects of ALKBH5, both in vitro and in vivo, significantly reducing collagen deposition and airway narrowing in LTS rats.<h4>Conclusion</h4>Our findings identify a novel ALKBH5-IGFBP4 regulatory axis that drives fibroblast activation and airway fibrosis in LTS.