APE-associated ischemia and pulmonary hypertension induce an increase in serum levels of cytokines and chemokines, including tumor necrosis factor–alpha (TNFα), interleukin (IL)-1β, IL-8, CX3CR1, CXCRL1, brain natriuretic peptide (BNP), troponin T, and D-dimer (Zagorski et al., 2003; Wang et al., 2013; Wang et al., 2014; Zhang et al., 2017; Shi et al., 2018). Here, NPPB is linked to ischemia.