“…Multiple cellular and molecular mechanisms are implicated in the development and progression of pulmonary vascular remodeling through enhanced PASMC proliferation and migration, such as the signaling cascades involving increases in intracellular free [Ca 2+ ], downregulation of K + channels and bone morphogenetic protein (BMP) receptors, upregulation of transforming growth factor-β (TGF-β) receptors, membrane receptors (e.g., Notch and CaSR) and Ca 2+ -permeable cation channels, and phosphorylation or activation of cytoplasmic kinases like AKT and mammalian target of rapamycin (mTOR) [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. However, the specific sequence of events involved in the enhanced PASMC proliferation in PH remains unclear.…”