ROS mediate proliferation by hypoxia, NOX4, and HIF-1α. (A and B) Pulmonary artery smooth-muscle cells (PASMCs) were treated with vitamin C (VitC, 100 μM) for 60 min before exposure to hypoxia for 4 h. (A) ROS levels were evaluated by DHE fluorescence. (B) Proliferative activity was determined by BrdU incorporation. Untreated cells (Ctr) were set to 100% (n = 3; *p < 0.05 vs. control, #p <0.05 vs. hypoxic control). (C and D) PASMCs were transfected with plasmids encoding for HIF-1α or NOX4 or control plasmid (Ctr) and treated with VitC for 60 min. (C) ROS levels were evaluated by DHE fluorescence. (D) Proliferative activity was determined by BrdU incorporation. Untreated cells (Ctr) were set to 100% (n = 3; *p < 0.05 vs. control, #p < 0.05 vs. hypoxic control).