15-HETE is crucial for the protection of PASMCs (pulmonary arterial smooth muscle cells) against cell death, and the SIRT1 pathway may provide a new strategy for pulmonary artery hypertension therapy, in part, by acting on nitric oxide, PI3/AKT and ERK1 and ERK2 pathways [146,147,148] to produce its beneficial actions indicating that a close interaction exists among BALs, SIRTs, PI3/AKT, and ERKs. Here, AKT1 is linked to pulmonary arterial hypertension.