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proposed the notion of a stable two-cell system between macrophages and fibroblasts, where fibroblasts secrete colony stimulating factor 1 (CSF-1), essential for the survival of macrophages, and in turn macrophages produce platelet-derived growth factor (PDGF) that is key in promoting the proliferation and maintenance of fibroblast populations ( via the release of pro-resolving lipids like resolvin D1 ( An important aspect that emerges from the understanding of the direct immune actions exerted by fibroblasts and the immune-stromal crosstalk is the appreciation that targeting the fibroblast may be as important as targeting the immune cells

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In this regard, the contribution of antioxidant substances may be of greater benefit in this category of patients, especially in the early stages of the disease