Schematic representation of altered heme metabolism in macrophages of idiopathic pulmonary fibrosis (IPF). These pulmonary macrophages might have lower heme and biliverdin levels, leading to increased oxidative stress and expression of proinflammatory cytokines that can exacerbate fibrosis. BVR, biliverdin reductase; CO, carbon monoxide; Fe2, free iron; HO-1, heme oxygenase-1; ROS, reactive oxygen species.