NOX4

NOX4 is a constitutively active NADPH oxidase that generates H2O2 and requires p22^phox^ for ROS production[1]. Mechanistically, isolated NOX4 directs most electron flux toward H2O2, and its high oxygen K~m~ supports oxygen-sensitive redox signaling[2]. Compared with NOX1 and NOX2, NOX4 preferentially forms H2O2 through its enlarged E-loop, which controls ROS product specificity[3]. Under hypoxia, HIF-1 induces NOX4 expression, linking NOX4 to oxygen-response pathways[4]. In fibrosis models, NOX4 mediates TGF-β1-induced fibroblast-to-myofibroblast differentiation through Smad2/3 activation[5]. In idiopathic pulmonary fibrosis, pulmonary fibroblasts show increased NOX4 expression, and NOX4 mediates TGF-β1-induced myofibroblast differentiation[6]. Therefore, NOX4 research should prioritize isoform-specific H2O2 biology, hypoxia signaling, and TGF-β-driven fibrotic remodeling rather than generalized ROS measurement.