These changes are driven by the upregulation of glucose transporter, GLUT-1, and Pyruvate dehydrogenase kinase 1, and increased activity of multifunctional enzyme CAD (Carbamoyl-phosphate synthetase 2, Aspartate transcarbamoylase, and Dihydroorotase) in PAH pericytes, both in vitro and in situ. Here, CAD is linked to pulmonary arterial hypertension.