This pathway facilitates the conversion of PKM1 isoforms to PKM2, which is essential for shifting cellular metabolism towards aerobic catabolism, thereby enhancing cellular aerobic glycolysis.84,85 In RV fibroblasts (RVFs) from MCT-PAH rats, there is an elevated expression of TGF-β, CTGF, and Drp1. The gene discussed is CCN2; the disease is pulmonary arterial hypertension.