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Considering that the Hedgehog pathway is implicated in the initiation and maintenance of PAAD [82] and NNMT is a potential downstream target gene of Hedgehog, the elevation of NNMT level in PAAD may be a result of the continuously activated Hedgehog signaling pathway
Its the perfect storm, really, and this combination of increased pressure inside the thin-walled capillary together with a negative alveolar pressure on the other side of the capillary wall creates a huge pressure difference across the capillary wall, causing rupture and EIPH

10.1016/j.jhep.2020.01.017 J Hepatol

Rapid swelling and release of GAGs prevented clear visualisation of cell nuclei
