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Endothelial dysregulation and proliferation in the intima, smooth muscle cell proliferation and resistance to apoptosis in the medial layer, and adventitial fibroblast activation collectively contribute to the narrowing of the vascular lumen, thus causing PH (Nie et al., 2020

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Recent studies have shown that cell-intrinsic metabolic remodeling is necessary to support cellular phenotypic changes and effector functions in response to various injuries