Table 1. Cancer hallmarks shared with PAH.

Cancer hallmarks32	Evidence found in PAH
Sustained proliferative signaling	• p21 and p27 implication19-23 • Src/STAT3/Pim1 axis activation28-30 • p38/MAPK activation12,13
Evasion from growth suppressors	• p53 is protective against PAH19 and p53 expression is downregulated in monocrotaline model of PAH23 • impaired function of SMAD pathways9,10
Active invasion and metastasis	None
Replicative immortality	None
Angiogenesis	Plexiform lesion6,18
Resistance to cell death	• Bad phosphorylation33 • Increased Bcl2 expression,26 • Mitochondrial membrane hyperpolarization34
Avoided immune destruction	None
Tumor promoting inflammation	Increased level of pro-inflammatory cytokines8
Genome instability and mutation	• Morphogenetic protein receptor 2 (BMPR2) mutation9,11 • Activin-like kinase 1 (ALK1) mutation • Polymorphisms found in the sequence coding for the serotonin transporter 5-HTT and the gene KCNA5 coding for the potassium channel Kv1.517
Deregulated cellular energetic	Warburg effect24,25