In a follow-up study, Otsuki et al. reported that monocytes overexpressing HERV-K dUTPase released HERV-K dUTPase in extracellular vesicles (EVs), causing pulmonary hypertension in mice in association with endothelial mesenchymal transition (EndMT) related to the induction of the transcription factors SNAIL/SLUG, and pro-inflammatory molecule IL-6 as well as vascular cell adhesion molecule 1 (VCAM1) [99]. Here, VCAM1 is linked to pulmonary hypertension.