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Additionally, research has illuminated potential mechanisms involved in TGF-β1-induced ASM remodeling, encompassing pathways such as the phosphorylation of p38 and ERK1/2 (284), the up-regulation of miR-181a and miR-328-3p through the suppression of phosphatase and tensin homolog (PTEN) protein and increased p-Akt/Akt ratio suggesting TGF-β1 induced ASM remodeling involves PTEN and Akt signaling pathway (285, 286), and the modulation of intracellular calcium levels [(Ca2+)i] and/or activation of Rho-associated protein kinase (ROCK) (287)
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