Increasing pulmonary vasoconstriction and pulmonary vascular remodeling are two important characteristics of hypoxic pulmonary hypertension (HPH). They are also important to the pathogenesis and progression of HPH. More and more studies demonstrated that HPH is a structural, not a functional disease. Under conditions of chronic generalized alveolar hypoxia, the complexity of pathologic structural remodeling has been demonstred throughout the entity of the pulmonary circulation and all the structural layers of the arterial wall. The changes include a) appearance of longitudinal oriented smooth muscle cells within the intima, b) the abnormal deposition of increased amounts of collagen and elastin within the adventitia, and c) muscularization of non-muscular intra-acinar vessels and medial smooth muscle cell hypertrophy and hyperplasia. Pulmonary artery smooth muscle cell (PASMC) is the main undertaker of pulmonary...
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