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At the same time, direct evidence shows that fibroblast migration is modulated through extracellular vesicles derived from macrophages [153], as the vesicles carry a rich cargo of growth factors, cytokines, and microRNAs that can alter the inflammatory milieu, promote angiogenesis, and directly or indirectly stimulate fibroblast proliferation and activation [151,153,154]

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SHH can activate cytoskeletal actin stability by activating T-Lymphoma Invasion and Metastasis-Inducing Protein 1/Rac Family Small GTPase 1, allowing the cells to migrate [97]