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Poyatos P, Gratacós M, Samuel K, Orriols R, Tura-Ceide O. Oxidative Stress and Antioxidant Therapy in Pulmonary Hypertension. Antioxidants (Basel) 2023; 12:1006. [PMID: 37237872 PMCID: PMC10215203 DOI: 10.3390/antiox12051006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Pulmonary hypertension (PH) is a progressive disease characterized by elevated artery pressures and pulmonary vascular resistance. Underlying mechanisms comprise endothelial dysfunction, pulmonary artery remodeling and vasoconstriction. Several studies have shown evidence of the critical role of oxidative stress in PH pathophysiology. Alteration of redox homeostasis produces excessive generation of reactive oxygen species, inducing oxidative stress and the subsequent alteration of biological molecules. Exacerbations in oxidative stress production can lead to alterations in nitric oxide signaling pathways, contributing to the proliferation of pulmonary arterial endothelial cells and smooth muscle cells, inducing PH development. Recently, antioxidant therapy has been suggested as a novel therapeutic strategy for PH pathology. However, the favorable outcomes observed in preclinical studies have not been consistently reproduced in clinical practice. Therefore, targeting oxidative stress as a therapeutic intervention for PH is an area that is still being explored. This review summarizes the contribution of oxidative stress to the pathogenesis of the different types of PH and suggests antioxidant therapy as a promising strategy for PH treatment.
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Affiliation(s)
- Paula Poyatos
- Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (P.P.); (M.G.)
- Department of Medical Sciences, Faculty of Medicine, University of Girona, 17003 Girona, Spain
| | - Miquel Gratacós
- Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (P.P.); (M.G.)
| | - Kay Samuel
- Scottish National Blood Transfusion Service, NHS National Services Scotland, Edinburgh EH14 4BE, UK
| | - Ramon Orriols
- Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (P.P.); (M.G.)
- Department of Medical Sciences, Faculty of Medicine, University of Girona, 17003 Girona, Spain
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), 28029 Madrid, Spain
| | - Olga Tura-Ceide
- Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (P.P.); (M.G.)
- Department of Medical Sciences, Faculty of Medicine, University of Girona, 17003 Girona, Spain
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), 28029 Madrid, Spain
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Vanillic Acid Attenuates Monocrotaline-Induced Pulmonary Arterial Hypertension by Enhancing NO Signaling Pathways. Nat Prod Commun 2022. [DOI: 10.1177/1934578x221128411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a severe progressive disease characterized by elevated mean pulmonary arterial pressure, right ventricular hypertrophy, and eventual progression to right heart failure and death. This study aimed to examine the effect of the natural product vanillic acid (VA) on monocrotaline (MCT)-induced PAH in rats. The arginase inhibitory activity and enzyme kinetic reaction of VA were also investigated. The results showed that VA could improve pulmonary arterial pressure, pulmonary artery vascular remodeling, and right ventricular remodeling induced by MCT in rats and reduce the degree of pulmonary tissue fibrosis. Moreover, VA downregulated the gene and protein expression levels of Hif-2α, Hif-1β, and Arg2 and increased the P-eNOS/eNOS levels, thus increasing nitric oxide (NO) levels in PAH rats. Furthermore, VA was determined to be a mixed competitive arginase inhibitor with an IC50 of 26.1 μM. In conclusion, the arginase inhibitor VA exerted protective effects on MCT-induced PAH and pulmonary vascular remodeling by enhancing NO signaling pathways.
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Walter PB, Hohman LS, Rokeby A, Lum JJ, Hagar R, Lavrisha L, Saulys A, Kuypers FA, Vichinsky E, Morris CR. The effects of glutamine supplementation on markers of apoptosis and autophagy in sickle cell disease peripheral blood mononuclear cells. Complement Ther Med 2022; 70:102856. [PMID: 35843474 DOI: 10.1016/j.ctim.2022.102856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES L-Glutamine was FDA-approved for sickle cell disease (SCD) in 2017, yet the mechanism(s)-of-action are poorly understood. This study investigates the potential activation of autophagy as a previously unexplored mechanism-of-benefit. DESIGN Prospective, open-label, 8-week, phase-2 trial of oral L-glutamine (10 g TID) in patients with SCD at risk for pulmonary hypertension identified by Doppler-echocardiography by an elevated tricuspid-regurgitant-jet-velocity (TRV)≥ 2.5 m/s. Peripheral blood mononuclear cells (PBMCs) were isolated from blood samples taken from SCD patients at baseline, two, four, six and eight weeks of glutamine therapy, and from controls at baseline; BAX (pro-apoptotic marker) and LC3-II/LC3-I (autophagy marker) were measured via western blot analysis to assess apoptosis and autophagy respectively. SETTING Comprehensive SCD Center in Oakland, California. RESULTS Patients with SCD (n = 8) had a mean age of 44 ± 16, 50% were male; 63% Hb-SS, and mean TRV= 3.1 ± 0.7 m/s. Controls' mean age (n = 5) was 32 ± 12% and 57% were male; all were Hb-AA with a mean TRV= 1.8 ± 0.6. At baseline, SCD-PBMCs had 2-times higher levels of BAX and LC3-I versus controls (both p = 0.03). Levels of BAX expression increased by 300% after 8-weeks of glutamine supplementation (p = 0.005); LC3-I protein levels decreased while LC3-II levels increased by 70%, giving a significant increase in the LC3-II/LC3-I ratio (p = 0.02). CONCLUSION PBMCs from glutamine-supplemented SCD patients have upregulated apoptotic and autophagy proteins. The parallel increase in BAX and the LC3-II / LC3-I ratio with glutamine supplementation suggest a possible role of autophagic cell death. The increase in apoptotic markers provide insight into a possible mechanism used by peripheral PBMCs during glutamine supplementation in patients with SCD.
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Affiliation(s)
- Patrick B Walter
- Department of Hematology/Oncology, UCSF-Benioff Children's Hospital Oakland, Oakland, CA, USA; Department of Biology, University of Victoria, Victoria, BC, Canada
| | - Leah S Hohman
- Snyder Institute for Chronic Diseases, Departments of Microbiology, Immunology and Infectious Disease, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Andrew Rokeby
- Department of Biology, University of Victoria, Victoria, BC, Canada
| | - Julian J Lum
- Biochemistry and Microbiology, University of Victoria, Victoria, BC, Canada; Trev and Joyce Deeley Research Centre, BC Cancer, Victoria, BC, Canada
| | - Robert Hagar
- Department of Hematology/Oncology, UCSF-Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Lisa Lavrisha
- Department of Hematology/Oncology, UCSF-Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Augusta Saulys
- Department of Emergency Medicine, UCSF-Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Frans A Kuypers
- Department of Hematology/Oncology, UCSF-Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Elliott Vichinsky
- Department of Hematology/Oncology, UCSF-Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Claudia R Morris
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA.
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Onalo R, Cilliers A, Cooper P, Morris CR. Arginine Therapy and Cardiopulmonary Hemodynamics in Hospitalized Children with Sickle Cell Anemia: A Prospective, Double-blinded, Randomized Placebo-controlled Clinical Trial. Am J Respir Crit Care Med 2022; 206:70-80. [PMID: 35426778 PMCID: PMC9954326 DOI: 10.1164/rccm.202108-1930oc] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Acute changes in cardiopulmonary hemodynamics that include tricuspid regurgitant jet velocity (TRV) elevation measured by Doppler echocardiography are often encountered during sickle cell vasoocclusive pain and acute chest syndrome (ACS). Arginine and nitric oxide depletion develop in patients with these complications. Arginine administration may therefore improve nitric oxide bioavailability and potentiate pulmonary vasodilatation. Objectives: To evaluate effects of l-arginine supplementation on Doppler indices of cardiopulmonary hemodynamics in children with sickle cell anemia experiencing pain. Methods: This was a prospective, double-blinded, randomized placebo-controlled trial of oral arginine in children with sickle cell anemia age 5-17 years hospitalized with severe pain and/or ACS. Measurements and Main Results: Blood biomarkers and Doppler echocardiographic indices of cardiopulmonary hemodynamics were measured before and after supplementation. The mean change in TRV, pulmonary artery systolic pressure, mean pulmonary artery pressure, and other indices of cardiopulmonary hemodynamics were tested with paired Student's t test and correlated with markers of arginine bioavailability using Pearson correlation. Sixty-six children were randomized into arginine versus placebo groups. An elevated TRV ⩾ 2.5 m/s was seen in 40 (61%) patients. A Day 5 Doppler echocardiogram was performed in 47 patients who remained hospitalized. A greater reduction in median TRV occurred in the arginine group than placebo (22.2%, n = 22 vs. 3.8%, n = 25; p < 0.01). A larger percentage increase in global arginine bioavailability was associated with a lower TRV after 5 days of supplementation (r = -0.533; P = 0.001). Significant differences in multiple indices of cardiopulmonary hemodynamics and mean N-terminal pro B-type brain natriuretic peptide were also noted after arginine therapy. Conclusions: Oral arginine supplementation improves cardiopulmonary hemodynamics during sickle cell disease vasoocclusive pain and ACS.Clinical trial registered with Pan African Clinical Trial Registry https://pactr.samrc.ac.za/Search.aspx (PACTR201611001864290).
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Affiliation(s)
- Richard Onalo
- Cardiology Unit, Department of Paediatrics, Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria
| | - Antoinette Cilliers
- Division of Paediatric Cardiology, Department of Paediatrics, Chris Hani Baragwanath Academic Hospital, and
| | - Peter Cooper
- Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Claudia R. Morris
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia;,Children’s Healthcare of Atlanta, Atlanta, Georgia; and,Center for Clinical and Translational Research of Children’s Healthcare of Atlanta and Emory University, Atlanta, Georgia
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Muller J, Attia R, Zedet A, Girard C, Pudlo M. An Update on Arginase Inhibitors and Inhibitory Assays. Mini Rev Med Chem 2021; 22:1963-1976. [PMID: 34967285 DOI: 10.2174/1389557522666211229105703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 11/22/2022]
Abstract
Arginase, which converts arginine into ornithine and urea, is a promising therapeutic target. Arginase is involved in cardiovascular diseases, parasitic infections and, through a critical role in immunity, in some cancers. There is a need to develop effective arginase inhibitors and therefore efforts to identify and optimize new inhibitors are increasing. Several methods of evaluating arginase activity are available, but few directly measure the product. Radiometric assays need to separate urea and dying reactions require acidic conditions and sometimes heating. Hence, there are a variety of different approaches available, and each approach has its own limits and benefits. In this review, we provide an update on arginase inhibitors, followed by a discussion on available arginase assays and alternative methods, with a focus on the intrinsic biases and parameters that are likely to impact results.
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Affiliation(s)
- Jason Muller
- PEPITE EA4267, Université de Bourgogne Franche-Comté, F-25030 Besançon, France
| | - Rym Attia
- PEPITE EA4267, Université de Bourgogne Franche-Comté, F-25030 Besançon, France
| | - Andy Zedet
- PEPITE EA4267, Université de Bourgogne Franche-Comté, F-25030 Besançon, France
| | - Corine Girard
- PEPITE EA4267, Université de Bourgogne Franche-Comté, F-25030 Besançon, France
| | - Marc Pudlo
- PEPITE EA4267, Université de Bourgogne Franche-Comté, F-25030 Besançon, France
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Chen W, Liu T, Liang Q, Chen X, Tao W, Fang M, Xiao Y, Chen L. miR-1283 Contributes to Endoplasmic Reticulum Stress in the Development of Hypertension Through the Activating Transcription Factor-4 (ATF4)/C/EBP-Homologous Protein (CHOP) Signaling Pathway. Med Sci Monit 2021; 27:e930552. [PMID: 33911065 PMCID: PMC8095088 DOI: 10.12659/msm.930552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Hypertension-related microRNA(miR)-1283 and its target gene, activating transcription factor-4 (ATF4), can regulate vascular endothelial dysfunction. This study aimed to explore whether miR-1283 prevents hypertension through targeting ATF4. Material/Methods Transcriptome sequencing was performed after overexpression or inhibition of miR-1283 in human amniotic epithelial cells (HAECs). After miR-1283 was overexpressed or inhibited in HAECs, ATF4+/− and wild-type mice were induced with a high-salt diet. We detected the expression of ATF4, C/EBP-homologous protein (CHOP), BH3-interacting domain death agonist (BID), Bcl-2, Bcl-2-like protein 11 (BIM), Bcl-2-like protein 1 (BCL-X), and caspase-3 by PCR and western blotting. We detected the changes of vasoactive substances including nitric oxide (NO), endothelin 1 (ET-1), endothelial protein C receptor (EPCR), thrombin (TM), and von Willebrand factor (vWF) by ELISA. Results Compared with that of the miR-1283- inhibited group, NO was higher in the miR-1283 overexpression group, while the expression of ET-1, EPCR, TM, and vWF were lower. Similarly, compared with that of the miR-1283 inhibited group, the expression of ATF4, CHOP, BID, BIM, and caspase-3 in the miR-1283 overexpression group was downregulated, while the expression of BCL-2 and BCL-X was upregulated (P<0.05). In vivo experiments showed the lack of ATF4 gene could prevent hypertension in mice induced by high-salt diet and protect endothelial function. Conclusions The mechanism of regulating blood pressure and endothelial function of the miR-1283/ATF4 axis was related to inhibiting endoplasmic reticulum stress and cell apoptosis through the ATF4/CHOP signaling pathway. Therefore, the miR-1283/ATF4 axis may be a target for the prevention and treatment of hypertension.
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Affiliation(s)
- Weihao Chen
- College of Chinese Medicine, Jinan University, Guangzhou, Guangdong, China (mainland)
| | - Tianhao Liu
- College of Chinese Medicine, Jinan University, Guangzhou, Guangdong, China (mainland)
| | - Qiuer Liang
- College of Chinese Medicine, Jinan University, Guangzhou, Guangdong, China (mainland)
| | - Xudong Chen
- College of Chinese Medicine, Jinan University, Guangzhou, Guangdong, China (mainland)
| | - Wencong Tao
- College of Chinese Medicine, Jinan University, Guangzhou, Guangdong, China (mainland)
| | - Meixia Fang
- College of Chinese Medicine, Jinan University, Guangzhou, Guangdong, China (mainland)
| | - Ya Xiao
- College of Chinese Medicine, Jinan University, Guangzhou, Guangdong, China (mainland)
| | - Liguo Chen
- College of Chinese Medicine, Jinan University, Guangzhou, Guangdong, China (mainland)
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Wonkam A, Chimusa ER, Mnika K, Pule GD, Ngo Bitoungui VJ, Mulder N, Shriner D, Rotimi CN, Adeyemo A. Genetic modifiers of long-term survival in sickle cell anemia. Clin Transl Med 2020; 10:e152. [PMID: 32898326 PMCID: PMC7423184 DOI: 10.1002/ctm2.152] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Sickle cell anemia (SCA) is a clinically heterogeneous, monogenic disorder. Medical care has less-than-optimal impact on clinical outcomes in SCA in Africa due to several factors, including patient accessibility, poor access to resources, and non-availability of specific effective interventions for SCA. METHODS Against this background, we investigated 192 African participants who underwent whole exome sequencing. Participants included 105 SCA patients spanning variable clinical expression: a "long survivor" group (age over 40 years), a "stroke" group (at least one episode of overt stroke), and a "random" group (patients younger than 40 years without overt cerebrovascular disease). Fifty-eight ethnically matched homozygous hemoglobin A controls were also studied. Findings were validated in an independently recruited sample of 29 SCA patients. Statistical significance of the mutational burden of deleterious and loss-of-function variants per gene against a null model was estimated for each group, and gene-set association tests were conducted to test differences between groups. RESULTS In the "long survivor" group, deleterious/loss-of-function variants were enriched in genes including CLCN6 (a voltage-dependent chloride channel for which rare deleterious variants have been associated with lower blood pressure) and OGHDL (important in arginine metabolism, which is a therapeutic target in SCA). In the "stroke" group, significant genes implicated were associated with increased activity of the blood coagulation cascade and increased complement activation, for example, SERPINC1, which encodes antithrombin. Oxidative stress and glutamate biosynthesis pathways were enriched in "long survivors" group. Published transcriptomic evidence provides functional support for the role of the identified pathways. CONCLUSIONS This study provides new gene sets that contribute to variability in clinical expression of SCA. Identified genes and pathways suggest new avenues for other interventions.
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Affiliation(s)
- Ambroise Wonkam
- Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
- Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
| | - Emile R. Chimusa
- Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
- Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
| | - Khuthala Mnika
- Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
| | - Gift Dineo Pule
- Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
| | - Valentina Josiane Ngo Bitoungui
- Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
| | - Nicola Mulder
- Computational Biology Division, Department of Integrative Biomedical Sciences, Institute for Infectious Disease and Molecular MedicineUniversity of Cape TownCape TownSouth Africa
| | - Daniel Shriner
- Center for Research on Genomics and Global HealthNational Human Genome Research InstituteNational Institutes of HealthBethesdaMarylandUSA
| | - Charles N. Rotimi
- Center for Research on Genomics and Global HealthNational Human Genome Research InstituteNational Institutes of HealthBethesdaMarylandUSA
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global HealthNational Human Genome Research InstituteNational Institutes of HealthBethesdaMarylandUSA
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Hayes D, Wilson KC, Krivchenia K, Hawkins SMM, Balfour-Lynn IM, Gozal D, Panitch HB, Splaingard ML, Rhein LM, Kurland G, Abman SH, Hoffman TM, Carroll CL, Cataletto ME, Tumin D, Oren E, Martin RJ, Baker J, Porta GR, Kaley D, Gettys A, Deterding RR. Home Oxygen Therapy for Children. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 2019; 199:e5-e23. [PMID: 30707039 PMCID: PMC6802853 DOI: 10.1164/rccm.201812-2276st] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: Home oxygen therapy is often required in children with chronic respiratory conditions. This document provides an evidence-based clinical practice guideline on the implementation, monitoring, and discontinuation of home oxygen therapy for the pediatric population. Methods: A multidisciplinary panel identified pertinent questions regarding home oxygen therapy in children, conducted systematic reviews of the relevant literature, and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach to rate the quality of evidence and strength of clinical recommendations. Results: After considering the panel’s confidence in the estimated effects, the balance of desirable (benefits) and undesirable (harms and burdens) consequences of treatment, patient values and preferences, cost, and feasibility, recommendations were developed for or against home oxygen therapy specific to pediatric lung and pulmonary vascular diseases. Conclusions: Although home oxygen therapy is commonly required in the care of children, there is a striking lack of empirical evidence regarding implementation, monitoring, and discontinuation of supplemental oxygen therapy. The panel formulated and provided the rationale for clinical recommendations for home oxygen therapy based on scant empirical evidence, expert opinion, and clinical experience to aid clinicians in the management of these complex pediatric patients and identified important areas for future research.
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