Figure 4.

Gender-specific outcome of oxidative stress. The lower antioxidant defense system and decreased pro-survival mechanisms promote severe, caspase-independent type of cell death [15,55], and activation of inflammatory signaling and fibrotic changes in pulmonary arteries and RV of males [15,20] (left panel). In contrast in females, the intense antioxidant protection and increased pro-survival pathways induce apoptotic cell death [55], increase proliferation of the survived vascular cells, and promote pulmonary vascular remodeling, while preserving RV function (right panel).