The enhanced efficacy of SB525334 described here compared ROCK inhibitors with the moderate efficacy of SD 208 offered by Zaiman and colleagues in curbing the MCT caused PAH pathologies, may be because of variations in pharmacokinetics of each ALK5 chemical or alternately to the number of days of treatment with the kinase inhibitors. It may also be possible that monitoring an individual animal with noninvasive, scientifically relevant echocardiographic readouts, before and after treatment, may supply a better view of the effect of ALK5 inhibition. Loss of BMPR II function after germ line mutation has been firmly linked to the development and progression of sporadic and familial types of iPAH. The others and we have demonstrated that vascular smooth muscle cells isolated from individuals with familial and sporadic iPAH show elevated ALK5 signaling. Taken together these findings imply that ALK5 signaling is managed by the BMPR II pathway in pulmonary vascular smooth muscle cells via mechanisms that haven't been fully elucidated. Indeed, a current study shows that individuals presenting a combination of heterozygous BMPR II strains and triggering polymorphisms in the TGF 1 gene are identified earlier in the day with familial iPAH and genetic penetrance is enhanced. Hence, understanding the molecular mechanisms that cause improved ALK5 because of this of loss of functional BMPR II signaling might be crucial in understanding the pathophysiological function for TGF /ALK5 signaling in familial and sporadic iPAH. In our own studies we have used SB525334 prophylactically to rats in the MCT model and have observed significant reduction of MCT induced PAH pathologies, confirming that the ALK5 path is definitely involved in the induction phase of MCT induced PAH in rats. Our model of the data presented here's that ALK5 represents an important pathophysiological role in the progression of established illness in the rat MCT model and more over, inhibition of the path might supply a novel therapeutic option for treating familial iPAH.