Fig. 5

Mechanisms of natural medicines for PAH treatment. The green box represented the modulatory effects of natural medicines for PAH in signalling pathway. The white box indicated that the confirmed pathways, proteins and phenomenon could trigger PAH. For example, the natural medicines downregulated HIF-1α pathway to inhibit oxidation stress response against PAH. Upregulation of BMPR2/Smad by natural medicines could reverse that the low expression of BMPR2 induced development of PAH. Evidently, the NO related pathways influenced the balance of ET-1 and NO for promoting PAH. The inflammation signalling pathways in PAH mainly refered to p38 MAPK, ERK MAPK, NF-κB p65, NLRP3, HMGB1 pathways. The PPARγ/PI3K/AKT, TGF-β-Smad3, PI3K/Akt/mTOR et al. signalling pathways regulated the proliferation of vascular cell in PAH. Moreover, the related signalling pathways of migration, apoptosis, and autophagy also were testified in PAH. Thus, the modulatory effects on specific pathways of natural medicines for PAH were clearly showed in the figure