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Complex pathway (1)

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Nice work on this complex pathway! A few pointers:

For the SMAD4 / SMAD2/3 activation of target gene expression, I think you should use the mim-transcription/translation interaction. Also, if you group the 4 target genes, you can just have one interaction going from SMAD4 to the group. And I'm not sure about the arrows from the target genes to the label describing the downstream physical implications. Maybe this is what they mean, but the publication figure doesn't show it.
Add an arrow from the physiological changes to diseases
In this case, it might increase readability to enclose the descriptive labels in rectangles, since they are quite long. You can do this by changing the labels shape type from None to Rectangle.