“…DDR inhibitors have shown some success, but the additional damage and associated detrimental effects on health across different vascular compartments cannot be ignored [ 49 , 67 , 70 , 73 ]. It is important to note that, by necessity, the majority of these studies are performed on PAH-vascular cells, PAECs and PASMCs, derived from end-stage tissues, since such cells cannot be obtained at earlier stages of the disease [ 39 , 40 , 42 , 44 , 45 , 46 , 47 , 48 , 49 , 61 , 66 , 67 , 70 , 73 , 77 , 78 , 88 , 89 ]. The dysfunctional DDR or augmented DNA damage could be the result of surrounding variables like inflammation, hypoxia etc.…”