Bioenergetics and metabolism of the pulmonary endothelium. Scientific session I: ReSPIRE 2025.

Session I of the inaugural biennial Research Symposium on Pulmonary Injury and Repair of the Endothelium (ReSPIRE) highlighted recent advances in endothelial bioenergetics and metabolism and their role in pulmonary vascular diseases. Emerging evidence suggests that the maladaptation of metabolic pathways in the lung endothelium contributes to the progression of the acute respiratory distress syndrome (ARDS) and pulmonary arterial hypertension (PAH). The conference highlighted several new aspects of endothelial metabolism, including the use of alternative fuel sources such as fructose and fatty acids, inflammatory signaling mediated by mitochondrial depolarization, bioenergetic reprogramming through isoform switching of genes during hypoxia, and feedback regulation of metabolism by hypercapnia. Ultimately, these findings point to future research directions aimed at identifying mechanisms of dysregulated endothelial metabolism, which could serve as therapeutic targets for pulmonary vascular diseases.