In PAH, DNA methylation mediates CpG site methylation in gene promoters and enhancer regions via DNA methyltransferases (DNMTs), leading to hypermethylation or hypomethylation of immune-metabolic related genes such as EIF2AK4, TCF7, and SOCS3 with concomitant abnormal expression, which enriches functions like T cell differentiation and participates in the pathological process of PAH (Benincasa et al., 2023; Hindmarch et al., 2025). This evidence concerns the gene EIF2AK4 and pulmonary arterial hypertension.