101
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Dhaun N, Macintyre IM, Melville V, Lilitkarntakul P, Johnston NR, Goddard J, Webb DJ. Effects of endothelin receptor antagonism relate to the degree of renin-angiotensin system blockade in chronic proteinuric kidney disease. Hypertension 2009; 54:e19-20. [PMID: 19652085 DOI: 10.1161/hypertensionaha.109.138263] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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102
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Chen CH, Chen HA, Yang KY, Yu WC, Liao HT, Huang DF. Clinical features and endothelin receptor antagonist in primary Sjögren's syndrome with pulmonary arterial hypertension. Scand J Rheumatol 2009; 35:245-7. [PMID: 16766376 DOI: 10.1080/03009740600765032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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103
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Sun XY, Hedner T, Feng Q, Edvinsson L. Inhibition of Endothelin (ET-1) Induced Pressor Responses by the Endothelin (ETA) Receptor Antagonist FR139317 in the Pithed Rat. Blood Press 2009; 1:108-12. [PMID: 1366258 DOI: 10.3109/08037059209077501] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The effects of the novel ETA receptor antagonist, FR 139317, on ET-1 induced blood pressure changes were studied in the pithed Sprague-Dawley rat. FR139317 in a dose of 0.025 mg/kg b.w. had no effect while 0.05-1 mg/kg b.w. dose dependently inhibited the pressor response to an i.v. bolus injection of ET6-1 (800 pmoles/kg). While FR139317 potently inhibited the magnitide and duration of the ET-1 induced pressor response, the ETA antagonist did not significantly influence the shortlasting initial depressor response. We conclude that FR139317 in the pithed rat potently inhibits ET-1 mediated pressor responses and that this agent may become a significant tool to elucidate the putative physiological and pathophysiological role of ETA receptor mediated responses.
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Affiliation(s)
- X Y Sun
- Department of Pharmacology and Clinical Pharmacology, University of Göteborg, Sweden
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104
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Abstract
BACKGROUND Pulmonary arterial hypertension is a devastating disease, which leads to right heart failure and premature death. Recent evidence suggests that endothelin receptor antagonists may be promising drugs in the treatment of pulmonary arterial hypertension. OBJECTIVES To evaluate the efficacy of endothelin receptor antagonists in pulmonary arterial hypertension. SEARCH STRATEGY We searched CENTRAL (Cochrane Central Register of Controlled Trials), MEDLINE, EMBASE, and the reference section of retrieved articles. Searches are current as of Februray 2008. SELECTION CRITERIA Randomised controlled trials (RCTs) or quasi-randomised controlled trials involving patients with pulmonary arterial hypertension. DATA COLLECTION AND ANALYSIS Five review authors independently selected studies, assessed study quality and extracted data. MAIN RESULTS Five new studies have been added to this updated review, which now includes 11 randomised controlled trials involving 1457 patients. All the trials were of relatively short duration (12 weeks to 6 months). After treatment, patients treated with endothelin receptor antagonists could walk on average 33.7 metres (95% confidence interval [CI] 24.9 to 42.5 metres) further than those treated with placebo in a 6 minute walk test. Endothelin receptor antagonists improved more patients' World Health Organization/New York Heart Association (WHO/NYHA) functional class status than placebo (odds ratio [OR] 1.6; 95% confidence interval [CI] 1.2 to 2.1), and reduced the odds of functional class deterioration compared to placebo (OR 0.26; 95% CI 0.16 to 0.42 ). There was a trend for endothelin receptor antagonists to reduce mortality (OR 0.48; 95% CI 0.21 to 1.09), and limited data suggest that endothelin receptor antagonists improve Borg dyspnoea score and cardiopulmonary haemodynamics in symptomatic patients. Hepatic toxicity was not common, and endothelin receptor antagonists were well tolerated in this population. AUTHORS' CONCLUSIONS Endothelin receptor antagonists can increase exercise capacity, improve WHO/NYHA functional class, prevent WHO/NYHA functional class deterioration, reduce dyspnoea and improve cardiopulmonary haemodynamic variables in patients with pulmonary arterial hypertension with WHO/NYHA functional class II and III. However, there was only a trend towards endothelin receptor antagonists reducing mortality in patients with pulmonary arterial hypertension. Efficacy data are strongest in those with idiopathic pulmonary hypertension.
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Affiliation(s)
- Chao Liu
- The First Hospital of Hebei Medical University, Donggang Road, Shijiazhuang, Hebei Province, China, 050031
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105
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Lu MH, Chao CF, Tsai SH, Chen JY, Chang LT. Autocrine Effects of Endothelin on In Vitro Proliferation of Vascular Smooth Muscle Cells from Spontaneously Hypertensive and Normotensive Rats. Clin Exp Hypertens 2009; 28:463-74. [PMID: 16820343 DOI: 10.1080/10641960600798747] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
According to previous studies, endothelin-1 (ET-1) is the most potent growth factor in the regulation of vascular smooth muscle cell (VSMC) proliferation in spontaneously hypertensive rats (SHR). To evaluate if the dominant effect of ET-1-induced VSMC proliferation is achieved by autocrine regulation, aortic smooth muscle cells from four-week-old SHR and WKY (Wistar-Kyoto) rats were cultured in 24-well dishes, and the effects of ET-1 on VSMC proliferation were determined by (a) 3H-thymidine incorporation assays with different ET-1 blocking treatments, including a specific anti-ET-1 antibody; BQ-123, an ETA receptor blocker; and BQ-788, an ETB receptor blocker; and (b) examining the ET-1 blockade on the effects of treatment with other growth factors, including thrombin and angiotension II (AT-II). These results demonstrated that the anti-ET-1 antibody, BQ-123, BQ-788, and BQ-123 plus BQ-788 all caused dose-dependent inhibition of proliferation. A 90% inhibitory effect was observed at the maximum doses used except for BQ-123. The ET-1 receptor blockers inhibited thrombin-induced VSMC growth; however, they did not efficiently inhibit AT-II-induced VSMC growth. These results indicate that the autocrine effects of ET-1 play a predominant role in the proliferation of VSMCs from SHR and WKY rats. They also suggest that thrombin-induced VSMC growth is mediated by the autocrine effects of ET-1, and angiotensin II-induced VSMC growth is mediated by other signal pathways.
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MESH Headings
- Angiotensin II/administration & dosage
- Animals
- Antihypertensive Agents/administration & dosage
- Aorta, Thoracic/cytology
- Autocrine Communication/drug effects
- Cell Proliferation/drug effects
- Dose-Response Relationship, Drug
- Endothelin Receptor Antagonists
- Endothelin-1/administration & dosage
- Hemostatics/administration & dosage
- Male
- Muscle, Smooth, Vascular/cytology
- Myocytes, Smooth Muscle/drug effects
- Oligopeptides/administration & dosage
- Oligopeptides/antagonists & inhibitors
- Peptides, Cyclic/administration & dosage
- Peptides, Cyclic/antagonists & inhibitors
- Piperidines/administration & dosage
- Piperidines/antagonists & inhibitors
- Rats
- Rats, Inbred SHR
- Rats, Inbred WKY
- Receptors, Endothelin/administration & dosage
- Signal Transduction/drug effects
- Thrombin/administration & dosage
- Vasoconstrictor Agents/administration & dosage
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Affiliation(s)
- Mei-Hua Lu
- Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan, Republic of China.
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106
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McLaughlin VV, Archer SL, Badesch DB, Barst RJ, Farber HW, Lindner JR, Mathier MA, McGoon MD, Park MH, Rosenson RS, Rubin LJ, Tapson VF, Varga J. ACCF/AHA 2009 expert consensus document on pulmonary hypertension a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association. J Am Coll Cardiol 2009; 53:1573-619. [PMID: 19389575 DOI: 10.1016/j.jacc.2009.01.004] [Citation(s) in RCA: 1125] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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107
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Manes A, Marinelli A, Palazzini M, Negro L, Leci E, Gambetti S, Bachetti C, Beciani E, Conficoni E, Branzi A, Galiè N. [Pulmonary arterial hypertension. Part II: Medical and surgical treatment]. G Ital Cardiol (Rome) 2009; 10:366-381. [PMID: 19603608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Treatment of pulmonary arterial hypertension (group 1 of clinical classification) has been recently characterized by important progresses, particularly in pharmacological therapy. Only until few years ago, patients with pulmonary arterial hypertension were treated with non-specific drugs, such as diuretics and digoxin for right heart failure and calcium-channel blockers in the minority of cases, responders to the acute vasoreactivity test. In addition, use of oral anticoagulant treatment was supported by uncontrolled studies. In the last 15 years (in particular in the last 8 years) different randomized controlled trials assessing the functional, clinical and hemodynamic efficacy of three classes of targeted drugs (prostanoids, endothelin receptor antagonists and phosphodiesterase type 5 inhibitors) with pulmonary vascular dilating and antiproliferative effects have been performed. This information has allowed the proposal of an evidence-based treatment algorithm. Treatment starts with general measures (physical activity, fertility control, respiratory tract infection, etc.) and supportive therapy (anticoagulant therapy, diuretics, oxygen, digoxin). Patients who respond to the acute vasoreactivity test (10% of idiopathic form) are treated with high doses of calcium-channel blockers, non-responders with targeted therapies either on monotherapy or combination. Usually an oral active drug is initiated and a second compound of a different class is combined in case of non-satisfactory response to the first treatment. Combination therapy should be performed only in specialized centers with large experience on use of targeted therapies and their relevant side effects. In case of failure of medical therapy, possible options are balloon atrial septostomy and/or listing for lung or heart-lung transplantation. As available treatments do not constitute a cure for pulmonary arterial hypertension, further progresses are expected in the near future.
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Affiliation(s)
- Alessandra Manes
- Centro di Diagnosi e Terapia dell'Ipertensione Polmonare, Istituto di Cardiologia, Azienda Ospedaliero-Universitaria, Bologna
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108
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109
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Abstract
The alveolar-capillary membrane serves as a barrier that prevents the accumulation of fluid in the alveolar space and restricts the diffusion of large solutes while facilitating an efficient gas exchange. When this barrier becomes dysfunctional, patients develop acute lung injury (ALI), which is characterized by pulmonary edema and increased lung inflammation that leads to a life-threatening impairment of gas exchange. In addition to the increase of inflammatory cytokines, plasma levels of endothelin-1 (ET-1), which is a primarily endothelium-derived vasoconstrictor, are increased in patients with ALI. As patients recover, ET-1 levels decrease, which suggests that ET-1 may not only be a marker of endothelial dysfunction but may have a role in the pathogenesis of ALI. While pulmonary edema accumulates, alveolar fluid clearance (AFC) is of critical importance, as failure to return to normal clearance is associated with poor prognosis in patients with pulmonary edema. AFC involves active transport mechanisms where sodium (Na(+)) is actively transported from the alveolar airspaces, across the alveolar epithelium, and into the pulmonary circulation, which creates an osmotic gradient that is responsible for the clearance of lung edema. In this article, we review the relevance of ET-1 in the development of ALI, not only as a vasoconstrictor molecule but also by inhibiting AFC via the activation of endothelial ET-B receptors and generation. Furthermore, this review highlights the therapeutic role of drugs such as beta-adrenergic agonists and, in particular, of endothelin receptor antagonists in patients with ALI.
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Affiliation(s)
- Alejandro P Comellas
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa 52242, USA.
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110
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Mucke HAM. Small-molecule endothelin receptor antagonists: a review of patenting activity across therapeutic areas. IDrugs 2009; 12:366-375. [PMID: 19517317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In the field of nonpeptide NCEs with endothelin receptor antagonist activity, a burst in corporate IP filings occurred in the 1990s once the human endothelin system had been characterized, but patent activity has declined in the past decade. Universities have not been active in this area of research to a degree that would have led to many patent applications. While three endothelin receptor antagonists (bosentan, sitaxentan and ambrisentan) are already available for the treatment of pulmonary arterial hypertension, the use of such compounds for the larger therapy areas of heart failure, cancer and nephropathy is still being evaluated in late-stage clinical trials. Marketed and advanced-stage endothelin receptor blockers have remarkably little chemical diversity; thus, the substantially larger chemical space defined by patenting remains to be explored.
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111
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Maeda S, Sugawara J, Yoshizawa M, Otsuki T, Shimojo N, Jesmin S, Ajisaka R, Miyauchi T, Tanaka H. Involvement of endothelin-1 in habitual exercise-induced increase in arterial compliance. Acta Physiol (Oxf) 2009; 196:223-9. [PMID: 18945274 DOI: 10.1111/j.1748-1716.2008.01909.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Habitual aerobic exercise results in a significant increase in central arterial compliance. Endothelin-1 (ET-1) is a potent endothelium-derived vasoconstrictor peptide and could play a role in mediating the habitual aerobic exercise-induced increase in central arterial compliance. The aim of the present study was to examine whether ET-1 is involved in the mechanisms underlying the increase in central arterial compliance with aerobic exercise training. METHODS Seven apparently healthy middle-aged and older (60 +/- 3 years) adults underwent systemic endothelin-A/B (ET(A/B))-receptor blockade (500 mg of Tracleer) before and after 12 weeks of aerobic exercise training (70 +/- 1% of maximal heart rate, 44 +/- 2 min day(-1), 4.4 +/- 0.1 days week(-1)). RESULTS Basal carotid arterial compliance (via simultaneous B-mode ultrasound and arterial applanation tonometry on the common carotid artery) increased significantly after exercise training. Resting plasma ET-1 concentration decreased significantly after exercise training. Before exercise intervention, carotid arterial compliance increased significantly with the administration of the ET(A/B)-receptor blockade. After training, however, increases in carotid arterial compliance previously observed with the ET(A/B)-receptor blockade before training were abolished. CONCLUSIONS Regular aerobic exercise training enhances central arterial compliance in middle-aged and older humans. The increase in arterial compliance was associated with the corresponding reduction in plasma ET-1 concentration as well as the elimination of ET-1-mediated vascular tone. These results suggest that reductions in ET-1 may be an important mechanism underlying the beneficial effect of exercise training on central artery compliance.
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Affiliation(s)
- S Maeda
- Center for Tsukuba Advanced Research Alliance, University of Tsukuba, Tsukuba, Ibaraki, Japan
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112
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Chung SD, Yu HJ. Novel treatments for men with lower urinary tract symptoms suggestive of benign prostate hyperplasia. J Formos Med Assoc 2009; 108:349-52. [PMID: 19443288 DOI: 10.1016/s0929-6646(09)60078-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Shiu-Dong Chung
- Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei, Taiwan
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113
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Abstract
The endothelin system appears to play an important role in the pathophysiology of congestive heart failure (CHF). Endothelin receptor antagonists represent a novel class of agents that are being evaluated for their potential benefits in treating various cardiovascular disorders. Bosentan is an orally active endothelin receptor antagonist that has been studied for the treatment of CHF. Early clinical experience with bosentan has confirmed some benefits on hemodynamic parameters in patients with CHF. Its role in slowing the progression of the disease and improving survival remains to be elucidated.
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Affiliation(s)
- S H Ellahham
- Division of Cardiology, Washington Hospital Center, DC 20010, USA
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114
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Abstract
Pulmonary arterial hypertension is a progressive, symptomatic, and ultimately fatal disorder for which substantial advances in treatment have been made during the past decade. Effective management requires timely recognition and accurate diagnosis of the disorder and appropriate selection among therapeutic alternatives. Despite progress in treatment, obstacles remain that impede the achievement of optimal outcomes. The current article provides an overview of the pathobiologic mechanisms of pulmonary arterial hypertension, including genetic substrates and molecular and cellular mechanisms, and describes the clinical manifestations and classification of pulmonary arterial hypertension. The article also reviews established approaches to evaluation and treatment, with emphasis on the appropriate application of calcium channel blockers, prostacyclin analogues, endothelin receptor antagonists, and phosphodiesterase 5 inhibitors. In addition, the authors discuss unresolved issues that may complicate patient management, such as the clinical importance of mild or exercise-related pulmonary arterial hypertension, and they identify avenues by which treatment may advance in the future through the use of combination treatment, outcomes assessment, and exploration of alternative pharmacologic strategies.
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Affiliation(s)
- Michael D McGoon
- Pulmonary Hypertension Clinic, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
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115
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Abstract
Pulmonary arterial hypertension is a progressive, symptomatic, and ultimately fatal disorder for which substantial advances in treatment have been made during the past decade. Effective management requires timely recognition and accurate diagnosis of the disorder and appropriate selection among therapeutic alternatives. Despite progress in treatment, obstacles remain that impede the achievement of optimal outcomes. The current article provides an overview of the pathobiologic mechanisms of pulmonary arterial hypertension, including genetic substrates and molecular and cellular mechanisms, and describes the clinical manifestations and classification of pulmonary arterial hypertension. The article also reviews established approaches to evaluation and treatment, with emphasis on the appropriate application of calcium channel blockers, prostacyclin analogues, endothelin receptor antagonists, and phosphodiesterase 5 inhibitors. In addition, the authors discuss unresolved issues that may complicate patient management, such as the clinical importance of mild or exercise-related pulmonary arterial hypertension, and they identify avenues by which treatment may advance in the future through the use of combination treatment, outcomes assessment, and exploration of alternative pharmacologic strategies.
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Affiliation(s)
- Michael D McGoon
- Pulmonary Hypertension Clinic, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
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116
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Mathai SC, Hummers LK, Champion HC, Wigley FM, Zaiman A, Hassoun PM, Girgis RE. Survival in pulmonary hypertension associated with the scleroderma spectrum of diseases: Impact of interstitial lung disease. ACTA ACUST UNITED AC 2009; 60:569-77. [PMID: 19180517 DOI: 10.1002/art.24267] [Citation(s) in RCA: 189] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
MESH Headings
- Bosentan
- Cohort Studies
- Comorbidity
- Endothelin Receptor Antagonists
- Female
- Follow-Up Studies
- Humans
- Hypertension, Pulmonary/diagnosis
- Hypertension, Pulmonary/drug therapy
- Hypertension, Pulmonary/mortality
- Isoxazoles/therapeutic use
- Lung Diseases, Interstitial/diagnosis
- Lung Diseases, Interstitial/drug therapy
- Lung Diseases, Interstitial/mortality
- Male
- Maryland/epidemiology
- Middle Aged
- Piperazines/therapeutic use
- Prognosis
- Proportional Hazards Models
- Purines/therapeutic use
- Receptors, Endothelin/physiology
- Scleroderma, Diffuse/diagnosis
- Scleroderma, Diffuse/drug therapy
- Scleroderma, Diffuse/mortality
- Scleroderma, Systemic/diagnosis
- Scleroderma, Systemic/drug therapy
- Scleroderma, Systemic/mortality
- Sildenafil Citrate
- Sulfonamides/therapeutic use
- Sulfones/therapeutic use
- Survival Rate
- Thiophenes/therapeutic use
- Vasodilator Agents/therapeutic use
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Affiliation(s)
- Stephen C Mathai
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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117
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Aneman A, Treggiari MM, Burgener D, Laesser M, Strasser S, Hadengue A. Tezosentan normalizes hepatomesenteric perfusion in a porcine model of cardiac tamponade. Acta Anaesthesiol Scand 2009; 53:203-9. [PMID: 19094177 DOI: 10.1111/j.1399-6576.2008.01834.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND To investigate endothelin-1 (ET-1)-dependent hepatic and mesenteric vasoconstriction, and oxygen and lactate fluxes in an acute, fixed low cardiac output (CO) state. METHODS Sixteen anesthetized, mechanically ventilated pigs were studied. Cardiac tamponade was established to reduce portal venous blood flow (Q(PV)) to 2/3 of the baseline value. CO, hepatic artery blood flow (Q(HA)), Q(PV), hepatic laser-Doppler flow (LDF), hepatic venous and portal pressure, and hepatic and mesenteric oxygen and lactate fluxes were measured. Hepatic arterial (R(HA)), portal (R(HP)) and mesenteric (R(mes)) vascular resistances were calculated. The combined ET(A)-ET(B) receptor antagonist tezosentan (RO 61-0612) or normal saline vehicle was infused in the low CO state. Measurements were made at baseline, after 30, 60, 90 min of tamponade, and 30, 60, 90 min following the infusion of tesozentan at 1 mg/kg/h. RESULTS Tamponade decreased CO, Q(PV), Q(HA), LDF, hepatic and mesenteric oxygen delivery, while hepatic and mesenteric oxygen extraction and lactate release increased. R(HA), R(HP) and R(mes) all increased. Ninety minutes after tesozentan, Q(PV), LDF and hepatic and mesenteric oxygen delivery and extraction increased approaching baseline values, but no effect was seen on CO or Q(HA). Hepatic and mesenteric handling of lactate converted to extraction. R(HA), R(HP) and R(mes) returned to baseline values. No changes were observed in these variables among control animals not receiving tesozentan. CONCLUSION In a porcine model of acute splanchnic hypoperfusion, unselective ET-1 blockade restored hepatomesenteric perfusion and reversed lactate metabolism. These observations might be relevant when considering liver protection in low CO states.
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Affiliation(s)
- A Aneman
- Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Göteborg, Sweden.
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118
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Mann CD, Metcalfe MS, Nicholson ML. Normothermic perfusion of ischaemic porcine kidneys: an evaluation of ex vivo function and endothelin receptor antagonism. J Nephrol 2009; 22:144-151. [PMID: 19229830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Non-heart-beating donors suffer a period of warm ischaemia (WI) injury, resulting in higher rates of delayed graft function compared with heart-beating donors. Endothelin is believed to play a pathophysiological role in the intense vasospasm associated with WI. This study aimed to investigate renal function using normothermic perfusion and potential therapeutic intervention with endothelin receptor antagonism. METHODS Porcine kidneys, subjected to varying periods of in situ WI (<10, 30 and 60 minutes), underwent normothermic machine perfusion with a perfluorodecalin perfusate. Intrarenal vascular resistance (IRR) was measured throughout perfusion, and urine and perfusate biochemical analysis was performed after 1 and 3 hours. Endothelin receptor antagonism was tested by administration of BQ-123 and BQ-788. RESULTS Initial IRR during perfusion increased with WI. IRR reduced to similar levels in all WI groups after 90 minutes of perfusion, but subsequently rose after 150 minutes. BQ-123 considerably increased the initial IRR; however, it abolished the rise seen towards the end of perfusion. BQ-788 had little effect. Renal metabolism and function deteriorated with increasing WI. Perfusion had adverse effects on renal function and metabolism. Endothelin receptor antagonism had little effect on renal function. CONCLUSIONS This study suggests that ex vivo assessment after normothermic perfusion correlates with warm ischaemic damage. However, endothelin receptor antagonism does not ameliorate the rise in IRR or renal function after kidneys are subjected to a warm ischaemic insult.
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Affiliation(s)
- Christopher D Mann
- Department of Transplant Surgery, University Hospital of Leicester, Leicester, UK.
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119
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Affiliation(s)
- Michael J Palmer
- Sandwich Discovery Chemistry, Pfizer Global Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, UK
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120
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Xu M, Dai DZ, Dai Y. Normalizing NADPH oxidase contributes to attenuating diabetic nephropathy by the dual endothelin receptor antagonist CPU0213 in rats. Am J Nephrol 2009; 29:252-6. [PMID: 18802327 DOI: 10.1159/000157628] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Accepted: 06/26/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS NADPH oxidase(NOX) is the main source of reactive oxygen species (ROS) in diabetic nephropathy (DN). Activation of NOX could be mediated via endothelin A (ET(A)R) and B receptors (ET(B)R) of the endothelin (ET) system. Thus, CPU0213, a dual ET receptor antagonist, was expected to attenuate DN by suppressing NOX. METHODS Diabetes was produced in male Sprague-Dawley rats 8 weeks after a single injection of streptozotocin (STZ), and treatment with CPU0213 was initiated in the last 4 weeks. Rat mesangial cells (MCs) were incubated with 30 mM glucose for 48 h supplemented with CPU0213 or the NOX inhibitors apocynin and diphenyleneiodonium. RESULTS After 8 weeks of hyperglycemia, abnormal renal function was associated with oxidative stress and an increased renal weight index in STZ-treated rats. Additionally, upregulation of NOX subunits and the ET system was found in diabetic rats and MCs treated with 30 mM glucose and suppressed by CPU0213 or NOX inhibitors. Except for blood glucose, CPU0213 markedly suppressed these abnormalities in DN. CONCLUSION Upregulation of NOX is associated with upregulation of the ET pathway in the pathology of DN. The dual ET receptor antagonist (ET(A)R and ET(B)R) CPU0213 effectively normalized renal function in DN by suppressing NOX.
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Affiliation(s)
- Ming Xu
- Research Division of Pharmacology, China Pharmaceutical University, Nanjing, China
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121
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Trojnarska O, Plaskota K. Therapeutic methods used in patients with Eisenmenger syndrome. Cardiol J 2009; 16:500-506. [PMID: 19950085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Patients with Eisenmenger syndrome form a small percentage of congenital heart disease patients. The rarity of this syndrome, combined with its complex pathophysiology, account for the insufficient understanding of the principles underlying its proper treatment. The main clinical symptoms are: cyanosis due to secondary erythrocytosis, resulting in increased blood viscosity, iron deficiency anemia (enhanced by unnecessary phlebotomies), blood clotting disturbances, heart failure and serious supraventricular and ventricular arrhythmias. Recent decades have seen developments in pulmonary hypertension pathophysiology which have led to the introduction of new groups of drugs: prostacycline analogs (Epoprostenol, Treprostinil, Beraprost, Illoprost), phosphodiesterase inhibitors (Sildenafil, Tadalafil), endothelin receptor antagonists (Bosentan, Sitaxantan, Ambrisentan) and nitric oxide. These drugs should be administered to patients in III-IV NYHA class. Despite successful early results, the therapeutic effect on patients with Eisenmenger syndrome has not been conclusively established. Our therapeutic efforts should be directed mainly towards preventing complications. As a rule, we should avoid agents with no established therapeutic efficacy and try to alleviate symptoms without any additional risk, so as not to disrupt the existing clinical balance.
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MESH Headings
- Anemia, Iron-Deficiency/etiology
- Anemia, Iron-Deficiency/prevention & control
- Antihypertensive Agents/therapeutic use
- Arrhythmias, Cardiac/etiology
- Arrhythmias, Cardiac/prevention & control
- Blood Coagulation Disorders/etiology
- Blood Coagulation Disorders/prevention & control
- Blood Viscosity
- Cyanosis/etiology
- Cyanosis/prevention & control
- Eisenmenger Complex/complications
- Eisenmenger Complex/diagnosis
- Eisenmenger Complex/drug therapy
- Eisenmenger Complex/etiology
- Eisenmenger Complex/physiopathology
- Eisenmenger Complex/therapy
- Endothelin Receptor Antagonists
- Female
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/physiopathology
- Humans
- Hypertension, Pulmonary/etiology
- Hypertension, Pulmonary/prevention & control
- Male
- Nitric Oxide/therapeutic use
- Phosphodiesterase Inhibitors/therapeutic use
- Polycythemia/etiology
- Polycythemia/prevention & control
- Pregnancy
- Pregnancy Complications, Cardiovascular/etiology
- Pregnancy Complications, Cardiovascular/prevention & control
- Prostaglandins I/therapeutic use
- Risk Reduction Behavior
- Treatment Outcome
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Affiliation(s)
- Olga Trojnarska
- 1st Cardiology Department, University of Medical Sciences, Poznań, Poland.
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Bosentan: new indication. Scleroderma and finger ulcers: no tangible efficacy. Prescrire Int 2008; 17:238. [PMID: 19422150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
No tangible clinical efficacy, but potentially severe adverse effects and a high potential for drug-drug interactions.
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Kamata Y, Iwamoto M, Minota S. [Treatment of pulmonary hypertension associated with connective tissue disease]. Nihon Rinsho Meneki Gakkai Kaishi 2008; 31:424-431. [PMID: 19122372 DOI: 10.2177/jsci.31.424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Pulmonary hypertension is the most ominous complication of connective tissue diseases and its treatment has been a big challenge to clinicians. Vasodilators including epoprostenol (prostacyclin), bosentan (endothelin-receptor antagonist), and a sildenafil (phosphodiesterase type 5 inhibitor) have recently become available in Japan. These vasodilators may improve exercise tolerance, hemodynamics, activities of daily life, and the life span. In this article, we review an endothelin-receptor antagonist and phosphodiesterase type 5 inhibitor recently approved as treatment modalities for pulmonary hypertension in Japan.
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Affiliation(s)
- Yasuyuki Kamata
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University
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Lteif AA, Fulford AD, Considine RV, Gelfand I, Baron AD, Mather KJ. Hyperinsulinemia fails to augment ET-1 action in the skeletal muscle vascular bed in vivo in humans. Am J Physiol Endocrinol Metab 2008; 295:E1510-7. [PMID: 18957616 PMCID: PMC2603554 DOI: 10.1152/ajpendo.90549.2008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Endogenous endothelin action is augmented in human obesity and type 2 diabetes and contributes to endothelial dysfunction and impairs insulin-mediated vasodilation in humans. We hypothesized that insulin resistance-associated hyperinsulinemia could preferentially drive endothelin-mediated vasoconstriction. We applied hyperinsulinemic-euglycemic clamps with higher insulin dosing in obese subjects than lean subjects (30 vs. 10 mU.m(-2).min(-1), respectively), with the goal of matching insulin's nitric oxide (NO)-mediated vascular effects. We predicted that, under these circumstances, insulin-stimulated endothelin-1 (ET-1) action (assessed with the type A endothelin receptor antagonist BQ-123) would be augmented in proportion to hyperinsulinemia. NO bioactivity was assessed using the nitric oxide synthase inhibitor N(G)-monomethyl-l-arginine. Insulin-mediated vasodilation and insulin-stimulated NO bioavailability were well matched across groups by this approach. As expected, steady-state insulin levels were approximately threefold higher in obese than lean subjects (109.2 +/- 10.2 pmol/l vs. 518.4 +/- 84.0, P = 0.03). Despite this, the augmentation of insulin-mediated vasodilation by BQ-123 was not different between groups. ET-1 flux across the leg was not augmented by insulin alone but was increased with the addition of BQ-123 to insulin (P = 0.01 BQ-123 effect, P = not significant comparing groups). Endothelin antagonism augmented insulin-stimulated NO bioavailability and NOx flux, but not differently between groups and not proportional to hyperinsulinemia. These findings do not support the hypothesis that insulin resistance-associated hyperinsulinemia preferentially drives endothelin-mediated vasoconstriction.
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Affiliation(s)
- Amale A Lteif
- Indiana Univ. School of Medicine, Indianapolis, IN 46202, USA
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126
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Simonneau G. [Pulmonary hypertension. Major therapeutic advances]. Rev Prat 2008; 58:1989-1990. [PMID: 19143269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Gérald Simonneau
- Hôpital Antoine-Béclère, université Paris-Sud, centre de référence de l'HTAP, département de pneumologie, 92141 Clamart Cedex, France.
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Jaïs X, Sitbon O, Savale L, Montani D, Humbert M, Simonneau G. [Pulmonary arterial hypertension]. Rev Prat 2008; 58:1997-2010. [PMID: 19143271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Pulmonary arterial hypertension (PAH) is a rare condition characterised by increased pulmonary vascular resistance leading to right heart failure and death. The clinical classification distinguishes idiopathic PAH, familial PAH, and PAH associated with other conditions (connective tissue disease, congenital heart disease, portal hypertension, human immunodeficiency virus infection, or appetite suppressant exposure). Echocardiography is the initial investigation of choice for non-invasive detection of PAH but measurement of pulmonary pressures and cardiac output during right heart catheterization is mandatory to confirm the diagnosis. Conventional therapy includes non-specific drugs (warfarin, diuretics). Intravenous epoprostenol is the first line treatment for the most severe patients. In the other situations, the first-line therapy may include bosentan, sildenafil, or a prostacyclin analogue. Recent advances in the management of PAH have markedly improved prognosis. The evolution of therapy from vasodilators to antiproliferative agents reflects the advancement in our understanding of the mechanisms mediating pulmonary arterial hypertension.
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Affiliation(s)
- Xavier Jaïs
- Centre de référence de l'hypertension pulmonaire sévère, service de pneumologie et réanimation respiratoire, hôpital Antoine-Béclère, 92141 Clamart Cedex, France.
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Fenhammar J, Andersson A, Frithiof R, Forestier J, Weitzberg E, Sollevi A, Hjelmqvist H. The endothelin receptor antagonist tezosentan improves renal microcirculation in a porcine model of endotoxemic shock. Acta Anaesthesiol Scand 2008; 52:1385-93. [PMID: 19025532 DOI: 10.1111/j.1399-6576.2008.01768.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Impaired renal microcirculation has been suggested as a factor contributing to the development of renal dysfunction in sepsis. This study was conducted to elucidate the role of endothelin-1 (ET-1)in mediating reductions in renal microcirculatory blood flow during endotoxemic shock. METHODS A prospective, randomized, and experimental study was performed with 16 anesthetized and mechanically ventilated pigs. After 2 h of lipopolysaccaride-induced endotoxemia, eight animals received a bolus dose of the dual endothelin receptor antagonist tezosentan (1 mg/kg), followed by a continuous infusion of 1 mg/kg/h throughout the experiment. Eight animals served as the control group. Renal microcirculation, total renal blood flow, plasma creatinine levels, cardiac index, and mean arterial pressure were measured. Plasma samples were collected for the measurement of tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), interleukin-10 (IL-10), ET-1, angiotensin II, and aldosterone. RESULTS Endotoxin infusion resulted in a state of circulatory shock with impairment of renal microcirculation. An increase in the plasma levels of TNF-alpha, IL-6, IL-10, ET-1, angiotensin II, and aldosterone was also observed. Tezosentan attenuated the decrease in renal microcirculation and renal blood flow, and attenuated the increase in plasma creatinine. Treatment with tezosentan did not significantly affect the plasma cytokine, angiotensin II, or aldosterone response to endotoxemia. CONCLUSION These results indicate that treatment with the dual endothelin receptor tezosentan in endotoxemic shock attenuates the reduction of renal microcirculation and total renal blood flow independently of plasma changes in the renin-angiotensin-aldosterone system or early plasma cytokine response.
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Affiliation(s)
- J Fenhammar
- Department of Anaesthesia and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
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129
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Okano Y. [Combination therapy]. Nihon Rinsho 2008; 66:2162-2167. [PMID: 19051737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The goal of combination therapy in patients with pulmonary arterial hypertension (PAH) is aimed at maximizing therapeutic efficacy while limiting toxicity and drug interactions. Because PAH is a rare disease, it is difficult to adequately power therapeutic trials to evaluate significant morbidity or mortality differences between various drug therapies. At this point, it is premature to either dismiss or strongly favor any one combination of therapies over another. There is debate among PAH specialists as to whether combination therapy should be reserved for patients whose condition deteriorates (add on therapy) or should be started up front and followed by maintenance therapy with one or more agents once patients have improved. Careful design of future trials testing these comparisons is very important.
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Affiliation(s)
- Yoshiaki Okano
- Clinical Laboratory Medicine, Graduate School of Medicine, Kyoto University
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130
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King TE. Bosentan for idiopathic pulmonary fibrosis. Curr Opin Investig Drugs 2008; 9:1171-1179. [PMID: 18951296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a debilitating, fatal, chronic fibrosing lung disease with no known effective therapy. Endothelin-1 may underlie the pathogenesis of lung fibrosis, therefore it was hypothesized that the oral dual endothelin receptor antagonist bosentan may have efficacy for the treatment of IPF. The BUILD-1 study evaluated the efficacy, safety and tolerability of bosentan in patients with IPF. Bosentan was associated with a trend toward delayed time to disease progression or death and improvement in quality-of-life, both of which were more pronounced in patients with a biopsy-confirmed IPF diagnosis. These observations are being investigated in the ongoing BUILD-3 trial.
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Affiliation(s)
- Talmadge E King
- University of California San Francisco, Department of Medicine, San Francisco, CA 94143-0120, USA.
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Huang XQ, Rao WL, Liu XY, Zhong YD, Lin T, Zhang CR, Zhu B. [A comparison study of post-cerebral hemorrhage stress ulcer with two interventional treatments aimed at endogenous endothelin in rat]. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 2008; 20:678-80. [PMID: 19000428 DOI: pmid/19000428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To observe the respective effects of intervention either with endothelin (ET) antibody or with ET receptor antagonist on acute stress ulcer (ASU) subsequent to cerebral hemorrhage in rats. METHODS Forty Sprague-Dawley (SD) rats were randomly divided into control group (group A, n=10), model group (group B, n=10), ET antibody (group C, n=10), and ET receptor antagonist group (group D, n=10). Right intracerebral hemorrhage was reproduced by injection of 200 microl autologous venous blood. Normal saline, ET antibody, or ET receptor antagonist was respectively administered intravenously per day for designated group. The rats were sacrificed at 3 days of the experiment. The incidence of ASU and ulcer index were assessed, serum ET-1 level, malondialdehyde (MDA) content and superoxide dismutase (SOD) activity in serum, Rsvmit (Rsv) and Vvmit (Vv) of cerebral and gastric mucosa were measured, and pathological examination of the cerebral tissue and gastric mucosa was performed with light microscopy and electron microscopy. RESULTS In group B, serum ET-1 level did not changed. MDA content were markedly increased in serum, cerebral and gastric mucosa, SOD activity were markedly decreased, cerebral water content were markedly increased; Rsv in neuron and gastric parietal cell, Vv in gastric parietal cell both were markedly decreased (P<0.05 or P<0.01). ASU was only observed in group B (the incidence was 30%, ulcer index was 15). It was not observed in other groups. Compared with group B, MDA content were significantly decreased, and SOD activity were significantly increased in serum, cerebral and gastric mucosa in groups C and D, cerebral water content in group C were dramatically decreased (all P<0.01), but these were not statistically different between groups C and D. Rsv and Vv in neuron and gastric parietal cell in groups B, C and D were not statistically different, and serum ET-1 level were not statistically different among the groups (all P>0.05). CONCLUSION Intervention of ET antibody and ET receptor antagonist can both reduce occurrence and development of ASU subsequent to cerebral hemorrhage in rats.
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Affiliation(s)
- Xing-qing Huang
- Department of Emergency, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan 512026, Guangdong, China.
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Emoto N, Matsuo N, Ohnishi T, Miyagawa K, Kato H, Iwasa N, Yoshida A, Kawai H, Hirata KI, Kuroda Y. [Remarkable response of bosentan, an endothelin receptor antagonist, for a patient with Eisenmenger syndrome]. Nihon Naika Gakkai Zasshi 2008; 97:2549-2551. [PMID: 19051748 DOI: 10.2169/naika.97.2549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Noriaki Emoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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133
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Richetta AG, Mattozzi C, Maiani E, D'Epiro S, Cimillio M, Carboni V, Giancristoforo S, Calvieri S. Efficacy of Bosentan in treatment of refractory sclerodermic bone prominences skin ulcers. Clin Ter 2008; 159:317-319. [PMID: 18998033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Scleroderma is an autoimmune disease characterized by skin and internal organs involvement. Cutaneous ulcerations is one of the most important complication. It may cause pain, disability and may lead to infections, scarring and amputation. Sclerodermic skin ulcers management is quite complex and involves non-pharmacologic and pharmacologic modalities both for the treatment and the prevention. In this report, authors describe a case of refractory skin ulcerations in a sclerodermic patient treated with endothelin receptor antagonist Bosentan. Bosentan changed the course of cutaneous lesions leading to their complete healing. This treatment represents an alternative therapeutic approach for sclerodermic skin ulcers and it may be taken into consideration for the ongoing development of a new management of cutaneous wounds.
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Affiliation(s)
- A G Richetta
- Dipartimento di Dermatologia e Venereologia e Chirurgia Plastica e Ricostruttiva, Università La Sapienza, Policlinico Umberto I, Roma, Italia.
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Jing ZC, Xu XQ, Ma CR, Wang Y, Wu Y, Jiang X, Pan L, Yang YJ. [Effects of bosentan in treatment of pulmonary arterial hypertension: a pilot study of 21 patients]. Zhonghua Yi Xue Za Zhi 2008; 88:2136-2139. [PMID: 19080476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To investigate the preliminary efficacy and safety of bosentan, a dual endothelin-receptor antagonist, in Chinese pulmonary arterial hypertension (PAH) patients. METHODS 21 patients with PAH, idiopathic or associated with congenital heart disease or connective-tissue disease received 62.5 mg of bosentan twice daily for 4 weeks, and then 125 mg twice daily for 8 weeks if without serious side effects. At week 12, the patients underwent 6 min walk test, hemodynamic variables examination, right heart catheterization, ultrasound cardiography, and electrocardiography. RESULTS The six-minute walking distance 12 weeks after bosentan treatment was 461 m +/- 84 m, significantly longer than that before the therapy (374 m +/- 113 m, P < 0.001). The pulmonary vascular resistance 12 weeks after the bosentan treatment was (1236 +/- 729) dyn x s(-1) x cm(-5), significantly lower than that before [(1,440 +/- 766) dyn x s(-1) x cm(-5), P = 0.007]. The cardiac index 12 weeks after the bosentan treatment was (3.02 +/- 1.71) L x min(-1)xm(2), significantly higher than that before treatment [(2.35 +/- 1.20) L x min(-1)xm(2), P = 0.002]. No patient was withdrawn from this study for safety reason. CONCLUSION Improves the exercise capacity and hemodynamic parameters in Chinese PAH patients; bosentan is safe in treating PAH and can be well tolerated.
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Affiliation(s)
- Zhi-Cheng Jing
- Department of Internal Medicine, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China.
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Lionnet F, Bachmeyer C, Stankovic K, Tharaux PL, Girot R, Aractingi S. Efficacy of the endothelin receptor blocker bosentan for refractory sickle cell leg ulcers. Br J Haematol 2008; 142:991-2. [PMID: 18671710 DOI: 10.1111/j.1365-2141.2008.07206.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Viel EC, Benkirane K, Javeshghani D, Touyz RM, Schiffrin EL. Xanthine oxidase and mitochondria contribute to vascular superoxide anion generation in DOCA-salt hypertensive rats. Am J Physiol Heart Circ Physiol 2008; 295:H281-8. [PMID: 18487445 PMCID: PMC2494748 DOI: 10.1152/ajpheart.00304.2008] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2008] [Accepted: 05/12/2008] [Indexed: 02/06/2023]
Abstract
Vascular superoxide anion (O(2)(*-)) levels are increased in DOCA-salt hypertensive rats. We hypothesized that the endothelin (ET)-1-induced generation of ROS in the aorta and resistance arteries of DOCA-salt rats originates partly from xanthine oxidase (XO) and mitochondria. Accordingly, we blocked XO and the mitochondrial oxidative phosphorylation chain to investigate their contribution to ROS production in mesenteric resistance arteries and the aorta from DOCA-salt rats. Systolic blood pressure rose in DOCA-salt rats and was reduced after 3 wk by apocynin [NAD(P)H oxidase inhibitor and/or radical scavenger], allopurinol (XO inhibitor), bosentan (ET(A/B) receptor antagonist), BMS-182874 (BMS; ET(A) receptor antagonist), and hydralazine. Plasma uric acid levels in DOCA-salt rats were similar to control unilaterally nephrectomized (UniNx) rats, reduced with allopurinol and bosentan, and increased with BMS. Levels of thiobarbituric acid-reacting substances were increased in DOCA-salt rats versus UniNx rats, and BMS, bosentan, and hydralazine prevented their increase. Dihydroethidium staining showed reduced O(2)(*-) production in mesenteric arteries and the aorta from BMS- and bosentan-treated DOCA-salt rats compared with untreated DOCA-salt rats. Increased O(2)(*-) derived from XO was reduced or prevented by all treatments in mesenteric arteries, whereas bosentan and BMS had no effect on aortas from DOCA-salt rats. O(2)(*-) generation decreased with in situ treatment by tenoyltrifluoroacetone and CCCP, inhibitors of mitochondrial electron transport complexes II and IV, respectively, whereas rotenone (mitochondrial complex I inhibitor) had no effect. Our findings demonstrate the involvement of ET(A) receptor-modulated O(2)(*-) derived from XO and from mitochondrial oxidative enzymes in arteries from DOCA-salt rats.
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Affiliation(s)
- Emilie C Viel
- Lady Davis Institute for Medical Research, Montreal, QC, Canada H3T 1E2
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Tang XY, Liu Q, Dai DZ, Dai Y. CPU0213, a novel endothelin receptor antagonist, suppresses the upregulation of matrix metalloproteinases and connexin 43 in hyperthyroid myocardium. Pharmacol Rep 2008; 60:524-531. [PMID: 18799821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2007] [Revised: 05/26/2008] [Indexed: 05/26/2023]
Abstract
It has been verified that endothelin-1 (ET-1) activates matrix metalloproteinase (MMP) in the process of myocardial remodeling. Sustained high thyroid hormone level gives rise to left ventricular hypertrophy, in which the ET-1 system is probably involved.We attempted to study the effects of CPU0213, a novel endothelin receptor antagonist, on myocardial remodeling induced by high dose L-thyroxin. Adult male Sprague-Dawley rats were treated with L-thyroxin (0.4 mg/kg/d, sc) for 10 days to induce left ventricular hypertrophy. Asubset of rats was given CPU0213 from day 6 to 10. Alterations in MMP, tissue inhibitor of metalloproteinase (TIMP), and connexin 43 were measured by reverse transcription polymerase chain reaction (RT-PCR), zymography, and Western blot assays. L-thyroxin treatment resulted in increased mRNA expression and MMP-2 and MMP-9 activities, along with decreased TIMP-1 and TIMP-2 mRNA expression. CPU0213 suppressed the increased activity of MMP, and prevented the downregulation of TIMP expression. The expression of connexin 43 was upregulated at both mRNAand protein levels after L-thyroxin treatment, which was attenuated by CPU0213. In addition, L-thyroxin caused upregulation of mRNA expression of preproET-1 (ppET-1) and endothelin converting enzyme (ECE). These results suggest that the ET receptors mediate high dose L-thyroxin induced myocardial remodeling by changing MMP, TIMP activities and connexin 43.
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Affiliation(s)
- Xiao-Yun Tang
- Research Division of Pharmacology, China Pharmaceutical University, Nanjing 210009, China
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Affiliation(s)
- Neeraj Dhaun
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK.
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140
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Sitaxentan: new drug. Pulmonary hypertension: better to continue to use bosentan. Prescrire Int 2008; 17:108. [PMID: 18630348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Abstract
BACKGROUND 2-Methoxyestradiol (2ME2) is an antitumoral and antiangiogenic compound that inhibits hypoxia-inducible factor (HIF)-1, a key regulator of the hypoxic response that promotes tumor progression. HIF-1alpha, the regulated subunit of HIF-1, is overexpressed in premalignant, cancerous and metastatic lesions of prostate. Endothelin (ET)-1 is a HIF target gene and one that plays an important role during prostate bone metastasis via its interaction with endothelin A (ET(A)) receptor. We reasoned that 2ME2 combined with an ET(A) receptor antagonist would induce potent cytotoxic effects in prostate cancer cells. METHODS PC-3 and LNCaP cells were grown alone or cocultured with human osteoblasts. The cells were treated with 2ME2, with an ET(A) receptor antagonist (BQ-123) or with combinations of both compounds. The cells were then evaluated for cytotoxicity, HIF-1alpha protein expression and HIF-1 transcriptional activity. RESULTS The combination of 2ME2 with BQ-123 induced synergistic cytotoxic effects in prostate cancer cells and in their cocultures with osteoblasts. No synergism was observed when 2ME2 was combined with the ET(B) selective antagonist, BQ-788. These results correlated with inhibition of HIF-1alpha protein expression, HIF-1 transcriptional activity, and PSA mRNA expression. CONCLUSIONS The ET(A) receptor antagonist was capable of potentiating the cytotoxic effects of 2ME2 in prostate cancer cells. These effects were apparently mediated through the inhibition of the HIF-1 pathway. Our in vitro data strengthen the rationale for using 2ME2 in combination with ET(A) receptor antagonists for the treatment of metastatic prostate cancer.
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Affiliation(s)
- Nicola J Mabjeesh
- Prostate Cancer Research Laboratory, Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
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Abstract
17beta-Estradiol (E2) has been shown to exert antiarrhythmic effect after myocardial infarction; however, the mechanisms remain unclear. This study was performed to determine whether E2 exerts beneficial effects through attenuated sympathetic hyperreinnervation after infarction. Two weeks after ovariectomy, female Wistar rats were assigned to coronary artery ligation or sham operation. Twenty-four hours after coronary ligation, rats underwent one of five treatments: 1) sc vehicle treatment (control), 2) sc E2 treatment, 3) sc E2 treatment + tamoxifen (a potent estrogen receptor antagonist), 4) bosentan (an endothelin receptor blocker), or 5) sc E2 treatment + bosentan and followed for 4 wk. Myocardial endothelin-1 and norepinephrine levels at the remote zone revealed a significant elevation in control infarcted rats, compared with sham-operated rats, which is consistent with sympathetic hyperinnervation after infarction. Sympathetic hyperinnervation was blunted after giving the rats either E2 or bosentan, assessed by immunohistochemical analysis of tyrosine hydroxylase, growth-associated protein 43 and neurofilament, and Western blotting and real-time quantitative RT-PCR of nerve growth factor. Arrhythmic scores during programmed stimulation in E2-treated infarcted rats were significantly lower than in control-infarcted rats. Addition of bosentan did not have additional beneficial effects, compared with rats treated with E2 alone. The beneficial effect of E2 on sympathetic hyperinnervation was abolished by tamoxifen. Our data indicated that E2 has a role for sympathetic hyperinnervation after infarction, probably through an endothelin-1-depedent pathway. Chronic administration of E2 after infarction may attenuate the arrhythmogenic response to programmed electrical stimulation.
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Affiliation(s)
- Tsung-Ming Lee
- Department of Medicine, Cardiology Section, Taipei Medical University and Hospital, 252, Wu-Hsing Street, Taipei, 110, Taiwan
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143
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Hussain N, Al Otaibi T, Nampoory MRN. Contrast media nephropathy: in depth review. Saudi J Kidney Dis Transpl 2008; 19:174-182. [PMID: 18310863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
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Zhou Y, Gu J, Xu LM. [Effect and mechanism of salvianolic acid B in attenuating elevated portal pressure in a rat model of portal hypertension induced by endothelin-1]. ACTA ACUST UNITED AC 2008; 5:61-4. [PMID: 17214938 DOI: 10.3736/jcim20070112] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To investigate the effects of salvianolic acid B (SA-B) on portal hypertension induced by endothelin-1 in rats. METHODS Twenty-eight Sprague-Dawley rats were randomly divided into four groups: ET-1 group, ET-1+SA-B group, ET-1+ET(A)R blocker (BQ-123) group and ET-1+ET(B)R blocker (BQ-788) group. The rats of ET-1+SA-B group underwent intragastrical administration of salvianolic acid B for five days before ET-1 injection, while in three other groups' drinking water was given. In BQ-123 group or BQ-788 group, an intravenous injection of BQ-123 or BQ-788 via femoral vein was administered 30 minutes prior to ET-1 injection. Then changes of portal pressure, cervical artery pressure and heart rate were monitored continuously. RESULTS After ET-1 injection, the portal pressure of all rats in the ET-1 group increased significantly, while slightly in groups that pretreated with SA-B, BQ-123 or BQ-788. CONCLUSION SA-B can attenuate the elevated portal pressure induced by ET-1 with effect similar to ETR blocker.
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Affiliation(s)
- Yang Zhou
- Institute of Liver Diseases, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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145
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Abstract
Digital ulcers (DU) at the hands are one of the more frequent and severe complications in systemic sclerosis. Data on their prevalence and distribution in the different subsets of disease are variable in the literature. We studied the frequency of DU in a cohort of 333 scleroderma patients followed in the last 10 years in our Unit. DU have been recorded in 133 patients (39,9%), more frequently in males, in patients with cutaneous diffuse form of disease and in patients with anti-Scl70 ANA specificity. Complications of DU have been observed in 12,3% of cases. Surgery of the hands has been required in 8,7% of patients. The more effective treatment of DU are i.v. prostanoids, performed usually in day hospital, with high costs for the National Health Service. Recently the efficacy of bosentan, an oral receptor antagonist of endothelin, has been demonstrated, thus opening new perspectives in the treatment of DU in systemic sclerosis.
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Affiliation(s)
- F Tiso
- Cattedra e U.O.C. di Reumatologia, Dipartimento di Medicina Clinica e Sperimentale, Policlinico Universitario, Padova, Italia
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146
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Patel TA, Belcher E, Warner TD, Harding SE, Mitchell JA. Identification and characterization of a dysfunctional cardiac myocyte phenotype: role of bacteria, Toll-like receptors, and endothelin. Shock 2008; 28:434-40. [PMID: 17558348 DOI: 10.1097/shk.0b013e31804a55a7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cardiac myocyte dysfunction is clearly identified as underlying the acute heart failure associated with bacterial infection, as well as the chronic syndrome following cardiac damage, but the mechanisms leading to dysfunction in each case are not fully established. It is thought that local hormones such as endothelin 1 (ET-1) can increase the risk of heart failure in acute or chronic conditions. In the current study, we characterize myocytes as populations and identify a novel phenotype of the ventricular cardiac myocyte that does not contract appropriately on electrical stimulation. The noncontractile cardiac myocytes were viable and had normal calcium transients. The proportion of noncontractile cardiac myocytes was increased by bacteria (gram-positive Staphylococcus aureus or gram-negative Escherichia coli). Using selective ligands or myocytes from genetically modified mice, we established that the effects of S. aureus were mediated by Toll-like receptor 2/6 and of E. coli by Toll-like receptor 4. The transition to the noncontractile phenotype was strongly inhibited by ETA antagonism but unaffected by inhibition of NOS, suggesting that ET-1 and not NO mediates this phenomenon. These results are the first to describe the characteristics of this noncontractile phenotype and the mechanisms of its induction by bacteria. Description of the myocyte population, instead of effects only on individual cells, will be more relevant to the prediction of the depression of cardiac function.
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Affiliation(s)
- Trupti A Patel
- Department of Cardiothoracic Pharmacology, National Heart and Lung Institute, Imperial College London, London, United Kingdom
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147
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Ianchuk PI, Rusinchuk II, Tieriekhov AA. [Effect of endothelin-1 on the liver oxygen balance and heat production]. Fiziol Zh (1994) 2008; 54:38-41. [PMID: 19227238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In acute experiments on anesthetized rats was shown, that endothelin-1 constricts arterial and portal vessels of the liver, reduces blood flow in the liver, supresses tissue respiration and heat production in this organ. Thus, the level of oxygen pressure in the liver might grow. The influence endothelin-1 on tissue respiration and heat production is mediated through ET(A)-receptors.
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148
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Galie N, Manes A, Palazzini M, Negro L, Marinelli A, Gambetti S, Mariucci E, Donti A, Branzi A, Picchio FM. Management of Pulmonary Arterial Hypertension Associated with Congenital Systemic-to-Pulmonary Shunts and Eisenmenger???s Syndrome. Drugs 2008; 68:1049-66. [PMID: 18484798 DOI: 10.2165/00003495-200868080-00004] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Nazzareno Galie
- Institute of Cardiology, University of Bologna, Bologna, Italy.
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149
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Abstract
The last decade has seen significant advances in the understanding and treatment of pulmonary arterial hypertension (PAH). Three main pathways, involving endothelin, nitric oxide, and prostacyclin, have been identified in its pathogenesis and these have all led to the development of therapies in current use. While the nitric oxide and prostacyclin pathways require augmentation, the endothelin system is overactive in PAH, with increased endothelin synthesis and receptor expression and, therefore, requires blockade. There are two known endothelin receptors. The type A receptor, expressed in pulmonary artery media, mediates vasoconstriction and remodeling, whereas the function of the type B receptor is more complex. Like the type A receptor, the type B receptor mediates vasoconstriction and remodeling effects when expressed on smooth muscle cells and (myo)fibroblasts, yet functions to clear endothelin from the circulation and induce release of endogenous nitric oxide and prostacyclin, when activated in the pulmonary artery endothelium. Consequently, it is not clear from in vitro data whether the optimal strategy is to block only the type A receptor or both receptors. Phase III clinical studies show clear short-term physiologic benefit with both dual and selective endothelin blockade in PAH. Longer-term experience with bosentan, a dual receptor antagonist, has shown improved outcomes compared with historic control data and comparable survival to intravenous prostacyclin therapy. The newer selective blockers, sitaxsentan and ambrisentan, appear to have similar short-term efficacy, but long-term data are as yet either lacking or unpublished. They may be less hepatotoxic than bosentan, although long-term follow-up of patients receiving bosentan has shown this is not a significant problem. On the basis of available evidence, the endothelin receptor antagonists have become first-line therapy for patients with PAH, except in the most severely affected who still require treatment with intravenous prostacyclin. Although their use as part of combination therapy with other agents is widespread, the evidence for this is not as robust, but appropriate investigation is underway.
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Affiliation(s)
- Laura C Price
- Department of Cardiac Sciences, National Pulmonary Hypertension Service, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
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150
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Kato GJ. Novel small molecule therapeutics for sickle cell disease: nitric oxide, carbon monoxide, nitrite, and apolipoprotein A-I. Hematology Am Soc Hematol Educ Program 2008; 2008:186-92. [PMID: 19074079 PMCID: PMC2778246 DOI: 10.1182/asheducation-2008.1.186] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A hemolysis-linked subphenotype of sickle cell disease (SCD), characterized by pulmonary hypertension, stroke, priapism and leg ulcers, is associated with decreased nitric oxide bioavailability and vasculopathy. Vasculopathy appears to have a multifactorial etiology, including mechanisms primarily that involve deficient nitric oxide (NO) signaling, but also involving altered function of NO synthase related to substrate availability and cooperating factors such as apolipoproteins. Improved understanding of the vascular pathophysiology of SCD has led to new vascular targets for translational research in SCD. This growing vascular therapeutics field in SCD is complementary to the ongoing efforts to reduce the morbidity of vaso-occlusive pain crisis. This presentation will review the current biology and translational clinical development of novel small molecules targeting sickle cell vasculopathy. Strategies targeting the hemeoxygenase-carbon monoxide pathway, the arginine-NO synthase-cGMP-phosphodiesterase 5 pathway, the nitrate-nitrite-NO pathway, and the apolipoprotein A-I pathways will be reviewed. In this context, current clinical trials of inhaled NO, CO, nitrite, sildenafil and apoA-I mimetics will be discussed.
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Affiliation(s)
- Gregory J Kato
- Critical Care Medicine Department, Clinical Center and the Pulmonary and Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, MD 20892-1476, USA
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