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In this review we discuss chronic graft\u2010Versus\u2010host disease (G\n                    <jats:italic>v<\/jats:italic>\n                    HD), progressive systemic sclerosis (PSS), idiopathic pulmonary fibrosis (IPF), primary myelofibrosis (PMF), chronic lung allograft dysfunction (CLAD) and VEXAS syndrome to explore potential mechanisms underlying these patterns of fibrosis. We propose the distribution of fibrosis reflects a complex interplay between aetiology, initiating stimuli, local immune response, tissue\u2010specific micro\u2010environment and host susceptibility. Distinguishing systemic and local drivers of fibrosis is needed to understand and explain these patterns. A deeper understanding of early, tissue\u2010specific events governing fibrotic responses may allow development of preventive and therapeutic strategies.\n                  <\/jats:p>","DOI":"10.1111\/ctr.70670","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:00:59Z","timestamp":1788166859000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["What Explains the Pattern of Fibrosis in Chronic Graft\u2010Versus\u2010Host Disease?"],"prefix":"10.1111","volume":"40","author":[{"given":"Mohammadamin","family":"Noorafrooz","sequence":"first","affiliation":[{"name":"Vali\u2010E\u2010Asr Reproductive Health Research Center Family Health Research Institute Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoda","family":"Kavosi","sequence":"additional","affiliation":[{"name":"Rheumatology Research Center Tehran 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