Abstract
Pulmonary arterial hypertension (PAH) is a progressive, life-threatening disease characterized by vascular remodeling, endothelial dysfunction, and chronic inflammation. Despite existing targeted therapies, long-term outcomes remain poor, underscoring the need for more effective treatment. This review summarizes recent advancements in PAH therapy, emphasizing the integration of conventional medicine of the key pathways with nanoparticle-mediated drug delivery systems (nano-DDS), transforming growth factor beta/bone morphogenetic protein receptor type II, tyrosine kinase-based interventions, immunotherapies targeting inflammation and immune imbalance, and emerging molecular targets, including NOTCH3/HES-5 and E-selectin. Nano-DDS has improved drug bioavailability and targeting, opening new therapeutic possibilities. This article also discusses innovative approaches, such as endothelial-like progenitor cell-based cell therapy and the ETRQβ-002 vaccine. Future advancements in PAH treatment may result from the integration of conventional drugs, nanotechnology, and immunotherapy through multidisciplinary efforts.