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Understanding the source of initial lung injury is central to understanding IPF. Proposed injurious agents include viruses [12, 13], autoantibodies [14], and chemicals including the reflux and aspiration of acid or nonacid material from the gastrointestinal tract (Figure 1).Figure 1: ???Epithelial hypothesis???: proposed mechanisms of alveolar epithelial injury and fibrosis in IPF.2.
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