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Kong K, Koontz D, Morse C, Roth E, Domsic RT, Simon MA, Stratton E, Buchholz C, Tobin-Finch K, Simms R, George MP, Hassoun PM, Farber H, Lafyatis R. A Pilot Study of Dimethyl Fumarate in Pulmonary Arterial Hypertension Associated with Systemic Sclerosis. J Scleroderma Relat Disord 2021; 6:242-246. [PMID: 35005243 DOI: 10.1177/23971983211016196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Given the poor treatment options for pulmonary arterial hypertension associated systemic sclerosis (SSc-PAH) patients, we sought to determine clinical safety and efficacy of Dimethylfumarate (DMF), an Nrf2 agonist, and the effects on biomarkers of oxidative stress on SSc-PAH in an exploratory interventional clinical trial. Objectives The primary objectives were to assess the safety and efficacy of treatment with DMF in patients with SSc-PAH. Methods This was an investigator-initiated, double-blind, randomized, placebo-controlled trial conducted at two sites in the United States. The primary safety endpoint was the incidence of serious adverse events (SAEs) and all adverse events (AEs) in DMF compared to placebo-treated patients. The primary efficacy endpoint was the change in 6MWD from baseline to the end of treatment at Week 24 in DMF compared to placebo-treated patients. Results Six participants were randomized to either placebo (n = 2) or DMF (n = 4). Baseline demographics were similar in both groups. A total of 25 adverse events (AEs) occurred in 6 subjects, with 14 AEs (56.0%) having occurred in DMF-treated subjects. 3 occurrences were identified as nausea AEs, and two participants withdrew due to nausea. One participant in the placebo group was withdrawn after a hospitalization SAE due to worsening of heart failure and shortness of breath secondary to anemia. One participant in each group completed protocol. Subjects in the DMF-treated group showed a non-significant reduced decline in 6MWD (relative mean change of -7.07%) from baseline to Week 24 as compared to placebo-treated subjects (relative mean change of -14.97%). Conclusion Patients treated for SSc-PAH with 2 and 3-drug regimens, as is now typical for these patients, tolerate DMF poorly. Our small samples size did not provide power to suggest efficacy. We suggest that Nrf2 is still a valid therapeutic target for future trials, using better tolerated Nrf2 agonists.
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Affiliation(s)
- Kristi Kong
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA
| | - Diane Koontz
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA
| | - Christina Morse
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA
| | - Eileen Roth
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA
| | - Robyn T Domsic
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA
| | - Marc A Simon
- Division of Cardiology, University of Pittsburgh, Pittsburgh, PA
| | - Eric Stratton
- Division of Rheumatology, Arthritis Center, Boston University, Boston, MA
| | - Connor Buchholz
- Division of Rheumatology, Arthritis Center, Boston University, Boston, MA
| | | | - Robert Simms
- Division of Rheumatology, Arthritis Center, Boston University, Boston, MA
| | - M Patricia George
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO
| | - Paul M Hassoun
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Harrison Farber
- Division of Pulmonary, Critical Care and Sleep Medicine, Tufts Medical Center, Boston, MA
| | - Robert Lafyatis
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA
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Benza R, Boucly A, Farber H, Frost A, Bansilal S, Meier C, Rahner C, Hoeper M. COMPARISON OF RISK DISCRIMINATION BETWEEN REVEAL RISK SCORE CALCULATORS IN PATIENTS FROM THE PATENT STUDIES OF RIOCIGUAT IN PULMONARY ARTERIAL HYPERTENSION. Chest 2020. [DOI: 10.1016/j.chest.2020.08.1865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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3
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Abston E, Moll M, Hon S, Govender P, Berman J, Farber H. Long-term outcomes of epoprostenol therapy in sarcoid associated pulmonary hypertension. Sarcoidosis Vasc Diffuse Lung Dis 2020; 37:184-191. [PMID: 33093782 PMCID: PMC7569545 DOI: 10.36141/svdld.v37i2.9150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/20/2020] [Indexed: 11/02/2022]
Abstract
Sarcoidosis-Associated Pulmonary Hypertension (SAPH) is a common finding in patients with chronic sarcoidosis and is associated with increased mortality. The optimal treatment for SAPH is not known; however, therapies approved for Group 1 pulmonary hypertension have improved hemodynamics and functional status. Prostanoids, including epoprostenol, have been therapeutic in short-term studies of SAPH, but long-term efficacy is unknown. In this study, we evaluated the long-term effect of epoprostenol therapy in 12 patients with SAPH. Hemodynamic assessment after an average of 4.1 years of epoprostenol therapy demonstrated significant improvement in mean pulmonary arterial pressure, pulmonary vascular resistance, and cardiac output; furthermore, patients demonstrated improved NYHA functional class. To evaluate further the long-term effect of epoprostenol, we compared survival of SAPH patients to a cohort of hemodynamically matched patients from the same center treated with epoprostenol for Idiopathic Pulmonary Arterial Hypertension (IPAH). Interestingly, there was no difference in survival, despite the additional systemic disease burden of the SAPH subjects. Subgroup analysis by Scadding stage demonstrated that Scadding stages 1-3 had improved survival compared to Scadding stage 4. These observations suggest that epoprostenol is an effective long-term therapy for patients with SAPH; it improves hemodynamics, functional class, and provides survival similar to that seen in a hemodynamically-matched cohort of IPAH patients. Furthermore, we identify a subgroup of SAPH patients (nonfibrotic lung disease Scadding 1-3) who may derive significant benefit from prostanoid therapy. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (2): 184-191).
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Torres F, Farber H, Ristic A, McLaughlin V, Adams J, Zhang J, Klassen P, Shanahan W, Grundy J, Hoffmann I, Cabell C, Escribano Subías P, Sood N, Keogh A, D'Souza G, Rubin L. Efficacy and safety of ralinepag, a novel oral IP agonist, in PAH patients on mono or dual background therapy: results from a phase 2 randomised, parallel group, placebo-controlled trial. Eur Respir J 2019; 54:1901030. [PMID: 31391223 DOI: 10.1183/13993003.01030-2019] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 01/24/2019] [Accepted: 06/18/2019] [Indexed: 11/05/2022]
Abstract
PURPOSE This phase 2 study was designed to assess the efficacy, safety and tolerability of immediate-release orally administered ralinepag, a selective, non-prostanoid prostacyclin receptor agonist with a 24-h terminal half-life, compared to placebo in adult patients with symptomatic pulmonary arterial hypertension (PAH). METHODS 61 PAH patients who were receiving standard care, including mono or dual PAH-targeted background therapy were randomised 2:1 to ralinepag (n=40) or placebo (n=21). The starting dose of ralinepag was 10 μg twice daily. Dosage was then up-titrated as tolerated over the course of the 9-week dose-titration period, to a maximum total daily dose of 600 μg (300 μg twice daily). The primary efficacy end-point was the absolute change in pulmonary vascular resistance (PVR) from baseline to week 22. Additional end-points included percentage change in PVR from baseline, other haemodynamic parameters, 6-min walk distance (6MWD) and safety and tolerability. RESULTS Ralinepag significantly decreased PVR by 163.9 dyn·s·cm-5 compared to an increase of 0.7 dyn·s·cm-5 with placebo (p=0.02); the least-squares mean change from baseline PVR was -29.8% compared with placebo (p=0.03). 6MWD increased from baseline by 36.2 m with ralinepag and 29.4 m with placebo (p=0.90). Serious adverse events occurred in 10% of ralinepag patients and 29% of placebo patients. Study discontinuations occurred in 13% of ralinepag patients and 10% of placebo patients. SUMMARY Ralinepag reduced PVR compared with placebo in PAH patients on mono (41%) or dual combination (59%) background therapy.
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Affiliation(s)
- Fernando Torres
- Pulmonary/Critical Care, UT Southwestern Medical Center, William P. Clements Jr University Hospital, Dallas, TX, USA
| | - Harrison Farber
- Pulmonary and Critical Care, Boston Medical Center, Boston University, Boston, MA, USA
| | - Arsen Ristic
- Dept of Cardiology, Clinical Center of Serbia and Belgrade University School of Medicine, Belgrade, Serbia
| | | | - John Adams
- Arena Pharmaceuticals, San Diego, CA, USA
| | | | | | | | | | | | | | - Pilar Escribano Subías
- Dept of Cardiology, Hospital Universitario 12 de Octubre, Complutense University, Madrid, Spain
| | | | - Anne Keogh
- Heart Transplant, St Vincent's Hospital, Sydney, Australia
| | | | - Lewis Rubin
- Division of Pulmonary and Critical Care Medicine, University of California, San Diego, CA, USA
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Ivy D, Rosenzweig EB, Elliott C, Farber H, Frantz R, Gomberg-Maitland M, Mu Y, Zhao C, Kenny E, Selej M, Benza R. RISK ASSESSMENT IN PEDIATRIC PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION (PAH): APPLICATION OF THE REVEAL 2.0 RISK CALCULATOR. Chest 2019. [DOI: 10.1016/j.chest.2019.08.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Farber H, McDowell MM, Alhourani A, Agarwal N, Friedlander RM. Duraplasty Type as a Predictor of Meningitis and Shunting After Chiari I Decompression. World Neurosurg 2018; 118:e778-e783. [PMID: 30026145 DOI: 10.1016/j.wneu.2018.07.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Expansile duraplasty is frequently performed during Chiari I decompression. Aseptic and bacterial meningitis are possible complications of this procedure. We sought to compare the rates of meningitis and subsequent need for cerebrospinal fluid (CSF) diversion with duraplasty using bovine pericardial (BPC) xenograft and allograft. METHODS We conducted a retrospective review of 112 patients who underwent Chiari I decompression. All patients underwent duraplasty with either allograft or BPC. Occurrence of postoperative lumbar punctures and associated data were recorded to determine rates of meningitis. Rates of subsequent shunting were also recorded. RESULTS Overall, 112 patients were included in the study: 30 underwent duraplasty with allograft (27%) and 82 received BPC (73%). A total of 26 patients developed postoperative meningitis (23 cases of chemical meningitis and 3 of bacterial meningitis). Rates of meningitis were higher in patients who received BPC than patients who received allograft (28% vs. 10%, respectively; P = 0.047). The rate of shunting was greater in patients with meningitis compared with patients without meningitis (56.5% vs. 5.75%, respectively; P < 0.0001). Moreover, 13 of the 15 patients (87%) in the BPC cohort who were shunted were found to have meningitis compared with 0 of the 3 shunted patients (0%) in the allograft cohort (P = 0.044). CONCLUSIONS We found that rates of total meningitis were greater in patients who underwent Chiari I decompression and duraplasty with BPC compared with an allograft. The rate of shunting was significantly higher for patients who developed meningitis after decompression compared with patients without meningitis.
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Affiliation(s)
- Harrison Farber
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Michael M McDowell
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ahmad Alhourani
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Robert M Friedlander
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Farber H, Badlam J, Frost A, Benza R, Austin E, Badesch D, Chung W, Poms A, Feldkircher K, Yu C, Pauciulo M, Nichols W, Elliott C. The United States Pulmonary Hypertension Scientific Registry (USPHSR): Objectives and Preliminary Data. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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8
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Benza R, Frost A, Elliott G, Austin E, Badesch D, Farber H, Chung W, Poms A, Feldkircher K, Yu C, Badlam J, Pauciulo M, Nichols W. INITIAL DATA FROM THE US PULMONARY HYPERTENSION REGISTRY: GENETICS AND DEMOGRAPHICS IN NEWLY DIAGNOSED PULMONARY ARTERIAL HYPERTENSION (PAH). J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32467-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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9
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Ghofrani A, Benza R, Uno H, Channick R, Delcroix M, Farber H, Galie N, Hennessy B, Jansa P, Mehta S, Perchenet L, Pulido T, Rosenberg D, Rubin L, Sastry BKS, Simonneau G, Sitbon O, De Souza R, Wei LJ, Torbicki A. Using controlled and real-world data in concert to assess survival in pulmonary arterial hypertension: Insights from SERAPHIN and REVEAL. Pneumologie 2018. [DOI: 10.1055/s-0037-1619326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Ghofrani
- Med. Klinik II/V, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
| | - R Benza
- Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania
| | - H Uno
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | - R Channick
- Massachusetts General Hospital; Harvard Medical School
| | | | - H Farber
- Boston University School of Medicine
| | - N Galie
- Istituto DI Malattie Dell'apparato Cardiovascolare, Università DI Bologna
| | - B Hennessy
- Actelion Pharmaceuticals Ltd, Allschwi, Switzerland
| | | | - S Mehta
- LHSC University Hospital, London, Ontario
| | - L Perchenet
- Actelion Pharmaceuticals Ltd, Allschwi, Switzerland
| | - T Pulido
- Ignacio Chávez National Heart Institute, Mexico City
| | - D Rosenberg
- Actelion Pharmaceuticals Ltd, Allschwi, Switzerland
| | - L Rubin
- Division of Pulmonary and Critical Care Medicine, University of California, San Diego Medical School
| | | | | | - O Sitbon
- Service de Pneumologie, Hôpital Bicêtre, Univ. Paris-Sud
| | - R De Souza
- Incor Heart Institute, University of Sao Paulo
| | - LJ Wei
- Harvard University, Boston, Massachusetts
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Abston E, Farber H. Pulmonary Cavity From Mycobacterium malmoense in an HIV-Infected Patient: Complicated by Bronchopleural Fistula. Open Forum Infect Dis 2018; 5:ofy023. [PMID: 29450215 DOI: 10.1093/ofid/ofy023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 01/17/2018] [Indexed: 11/14/2022] Open
Abstract
We present a case of M. malmoense and HIV co-infection complicated by aspergilloma leading to bronchopleural fistula with intractable pneumothorax and pleural aspergillosis, ultimately requiring surgical intervention. Treatment guidelines for M. malmoense are reviewed, literature regarding M. malmoense and HIV co-infection is reviewed, and the epidemiology of M. malmoense in North America is discussed.
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Affiliation(s)
- Eric Abston
- Division of Pulmonary, Allergy, Sleep, and Critical Care Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Harrison Farber
- Division of Pulmonary, Allergy, Sleep, and Critical Care Medicine, Boston University School of Medicine, Boston, Massachusetts
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11
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Woroniecka K, Chongsathidkiet P, Elsamadicy A, Farber H, Cui X, Fecci PE. Flow Cytometric Identification of Tumor-Infiltrating Lymphocytes from Glioblastoma. Methods Mol Biol 2018; 1741:221-226. [PMID: 29392704 DOI: 10.1007/978-1-4939-7659-1_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We describe an isolation method of tumor-infiltrating lymphocytes (TILs) from glioblastoma tumors for the purpose of analysis by flow cytometry. This protocol is unique from many others in that the use of a selective lymphocyte isolation procedure, such as a Ficoll or Percoll gradient, is not used. We find that staining of TILs and analysis by flow cytometry is not affected by the presence of heterogeneous populations, while other selective isolation procedures can significantly decrease lymphocyte yield from already rare populations.
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Affiliation(s)
- Karolina Woroniecka
- Department of Pathology, Duke University Graduate School, Durham, NC, USA
- Duke University School of Medicine, Durham, NC, USA
| | | | | | | | - Xiuyu Cui
- Duke University School of Medicine, Durham, NC, USA
| | - Peter E Fecci
- Department of Pathology, Duke University Graduate School, Durham, NC, USA.
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
- Preston Robert Tisch Brain Tumor Center at Duke University, Durham, NC, USA.
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12
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Torres F, Farber H, Ristić A, McLaughlin V, Adams J, Zhang J, Klassen P, Escribano Subías P, Sood N, Keogh A, Rubin L. Hemodynamic Effects of the Oral Prostacyclin (IP) Receptor Agonist Ralinepag in Pulmonary Arterial Hypertension. Chest 2017. [DOI: 10.1016/j.chest.2017.08.768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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13
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14
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Farber H, Badesch D, Benza R, Elliott CG, Frantz R, McGoon M, Selej M, Zhao C, Frost A. Home Oxygen Use Characteristics and Outcomes in Patients With PAH: Data From the Reveal Registry. Chest 2016. [DOI: 10.1016/j.chest.2016.08.1263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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15
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Tapson V, Channick R, Chin K, Di Scala L, Farber H, Gaine S, Galiè N, Ghofrani H, Lang I, McLaughlin V, Preiss R, Rubin L, Simonneau G, Sitbon O, Hoeper M. Anticoagulant Therapy Is Not Associated with Long Term Outcome in Patients with Pulmonary Arterial Hypertension (PAH): Insights from the GRIPHON Study. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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16
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Verla T, Adogwa O, Elsamadicy A, Moreno JR, Farber H, Cheng J, Bagley CA. Effects of Psoas Muscle Thickness on Outcomes of Lumbar Fusion Surgery. World Neurosurg 2016; 87:283-9. [DOI: 10.1016/j.wneu.2015.11.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/08/2015] [Accepted: 11/12/2015] [Indexed: 11/26/2022]
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17
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Benza R, Frost A, Farber H, Ghofrani HA, Gómez-Sánchez M, Langleben D, Rosenkranz S, Busse D, Meier C, Nikkho S, Hoeper M. Application of REVEAL Risk Score to Patients With PAH Receiving Riociguat in the PATENT-2 Study. Chest 2015. [DOI: 10.1378/chest.2280692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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18
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Gupta A, Farmer MJ, Farber H. A Case of Pulmonary Hypertension Associated With High Cardiac Output State From Arteriovenous Fistula or Is It? Chest 2015. [DOI: 10.1378/chest.2281114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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19
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Farber H, Finch K, Stratton E. TREATMENT OF PULMONARY ARTERIAL HYPERTENSION ASSOCIATED WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION: A PILOT STUDY OF RANOLAZINE. Chest 2013. [DOI: 10.1378/chest.1759103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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20
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Frantz R, Chakinala M, Barst R, Schilz R, Chin K, Hemnes A, Miller D, Benton W, Hartline B, Farber H. Bloodstream Infection Rates in Patients With Pulmonary Arterial Hypertension Treated With Epoprostenol for Injection: A PROSPECT Registry Analysis. Chest 2012. [DOI: 10.1378/chest.1387084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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21
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Garzon-Muvdi T, Schiapparelli P, ap Rhys C, Guerrero-Cazares H, Smith C, Kim DH, Kone L, Farber H, Lee DY, An SS, Levchenko A, Quiñones-Hinojosa A. Regulation of brain tumor dispersal by NKCC1 through a novel role in focal adhesion regulation. PLoS Biol 2012; 10:e1001320. [PMID: 22570591 PMCID: PMC3341330 DOI: 10.1371/journal.pbio.1001320] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 03/21/2012] [Indexed: 12/21/2022] Open
Abstract
Glioblastoma (GB) is a highly invasive and lethal brain tumor due to its universal recurrence. Although it has been suggested that the electroneutral Na(+)-K(+)-Cl(-) cotransporter 1 (NKCC1) can play a role in glioma cell migration, the precise mechanism by which this ion transporter contributes to GB aggressiveness remains poorly understood. Here, we focused on the role of NKCC1 in the invasion of human primary glioma cells in vitro and in vivo. NKCC1 expression levels were significantly higher in GB and anaplastic astrocytoma tissues than in grade II glioma and normal cortex. Pharmacological inhibition and shRNA-mediated knockdown of NKCC1 expression led to decreased cell migration and invasion in vitro and in vivo. Surprisingly, knockdown of NKCC1 in glioma cells resulted in the formation of significantly larger focal adhesions and cell traction forces that were approximately 40% lower than control cells. Epidermal growth factor (EGF), which promotes migration of glioma cells, increased the phosphorylation of NKCC1 through a PI3K-dependant mechanism. This finding is potentially related to WNK kinases. Taken together, our findings suggest that NKCC1 modulates migration of glioma cells by two distinct mechanisms: (1) through the regulation of focal adhesion dynamics and cell contractility and (2) through regulation of cell volume through ion transport. Due to the ubiquitous expression of NKCC1 in mammalian tissues, its regulation by WNK kinases may serve as new therapeutic targets for GB aggressiveness and can be exploited by other highly invasive neoplasms.
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Affiliation(s)
- Tomas Garzon-Muvdi
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Paula Schiapparelli
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Colette ap Rhys
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Hugo Guerrero-Cazares
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Christopher Smith
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Deok-Ho Kim
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Bioengineering, University of Washington, Seattle, Washington, United States of America
| | - Lyonell Kone
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Harrison Farber
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Danielle Y. Lee
- Department of Environmental Health Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Steven S. An
- Department of Environmental Health Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Physical Sciences in Oncology Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Andre Levchenko
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Alfredo Quiñones-Hinojosa
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Hu YL, De Lay M, Rose SD, Carbonell WS, Aghi MK, Rose SD, Carbonell WS, De Lay M, Hu YL, Paquette J, Tokuyasu T, Tsao S, Chaumeil M, Ronen S, Aghi MK, Matlaf LA, Soroceanu L, Cobbs C, Soroceanu L, Matlaf L, Harkins L, Cobbs C, Garzon-Muvdi T, Rhys CA, Smith C, Kim DH, Kone L, Farber H, An S, Levchenko A, Quinones-Hinojosa A, Lemke D, Pfenning PN, Sahm F, Klein AC, Kempf T, Schnolzer M, Platten M, Wick W, Smith SJ, Rahman R, Rahman C, Barrow J, Macarthur D, Rose F, Grundy RG, Kaley TJ, Huse J, Karimi S, Rosenblum M, Omuro A, DeAngelis LM, de Groot JF, Kong LY, Wei J, Wang T, Piao Y, Liang J, Fuller GN, Qiao W, Heimberger AB, Jhaveri N, Cho H, Torres S, Wang W, Schonthal A, Petasis N, Louie SG, Hofman F, Chen TC, Yamada R, Sumual S, Buljan V, Bennett MR, McDonald KL, Weiler M, Pfenning PN, Thiepold AL, Jestaedt L, Gronych J, Dittmann LM, Jugold M, Kosch M, Combs SE, von Deimling A, Weller M, Bendszus M, Platten M, Wick W, Kwiatkowska A, Paulino V, Tran NL, Symons M, Stockham AL, Borden E, Peereboom D, Hu Y, Chaturbedi A, Hamamura M, Mark E, Zhou YH, Abbadi S, Guerrero-Cazares H, Pistollato F, Smith CL, Ruff W, Puppa AD, Basso G, Quinones-Hinojosa A, Monje M, Freret ME, Masek M, Fisher PG, Haddix T, Vogel H, Kijima N, Hosen N, Kagawa N, Hashimoto N, Fujimoto Y, Kinoshita M, Sugiyama H, Yoshimine T, Anneke N, Bob H, Pieter W, Arend H, William L, Eoli M, Calleri A, Cuppini L, Anghileri E, Pellegatta S, Prodi E, Bruzzone MG, Bertolini F, Finocchiaro G, Zhu D, Hunter SB, Vertino PM, Van Meir EG, Cork SM, Kaur B, Cooper L, Saltz JH, Sandberg EM, Van Meir EG, Burrell K, Hill R, Zadeh G, Parker JJ, Dionne K, Massarwa R, Klaassen M, Niswander L, Kleinschmidt-DeMasters BK, Waziri A, Jalali S, Wataya T, Salehi F, Croul S, Gentili F, Zadeh G, Jalali S, Foltz W, Burrell K, Lee JI, Agnihorti S, Menard C, Chung C, Zadeh G, Torres S, Jhaveri N, Wang W, Schonthal AH, Louie SG, Hofman FM, Chen TC, Elena P, Faivre G, Demopoulos A, Taillibert S, Rosenblum M, Omuro A, Kirsch M, Martin KD, Bertram A, uckermann O, Leipnitz E, Weigel P, Temme A, Schackert G, Geiger K, Gerstner E, Jennings D, Chi AS, Plotkin S, Kwon SJ, Pinho M, Polaskova P, Batchelor TT, Sorensen AG, Hossain MB, Gururaj AE, Cortes-Santiago N, Gabrusiewicz K, Yung WKA, Fueyo J, Gomez-Manzano C, Gil OD, Noticewala S, Ivkovic S, Esencay M, Zagzagg D, Rosenfeld S, Bruce JN, Canoll P, Chang JH, Seol HJ, Weeks A, Smith CA, Rutka JT, Georges J, Samuelson G, Misra A, Joy A, Huang Y, McQuilkin M, Yoshihiro A, Carpenter D, Butler L, Feuerstein B, Murphy SF, Vaghaiwalla T, Wotoczek-Obadia M, Albright R, Mack D, Lawn S, Henderson F, Jung M, Dakshanamurthy S, Brown M, Forsyth P, Brem S, Sadr MS, Maret D, Sadr ES, Siu V, Alshami J, Trinh G, Denault JS, Faury D, Jabado N, Nantel A, Del Maestro R. ANGIOGENESIS AND INVASION. Neuro Oncol 2011; 13:iii1-iii9. [PMCID: PMC3222963 DOI: 10.1093/neuonc/nor147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
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McGoon M, Frost A, Miller D, Barst R, Elliott CG, Farber H, Lai G, Poms A, Badesch D, Liou T, Benza R. Four-Year Outcomes of Patients With Pulmonary Arterial Hypertension: Risk, Prognosis, and the Disease Duration Continuum. Chest 2011. [DOI: 10.1378/chest.1119437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Badesch D, Farber H, McGoon M, Frost A, Elliott CG, Benza R, Poms A, Miller D, Barst R. Hepatic Transaminase Abnormalities in Pulmonary Arterial Hypertension: A Report From the REVEAL Registry. Chest 2011. [DOI: 10.1378/chest.1119558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Farber H, Miller D, Beery F, McGoon M. Use of Parenteral Prostanoids at Time of Death in Patients With Pulmonary Arterial Hypertension Enrolled in REVEAL. Chest 2011. [DOI: 10.1378/chest.1118152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Frost A, Miller D, Farber H, McGoon M, Barst R, Elliott C. 123: REVEAL Registry: Prevalence, Demographics and Outcomes in Patients with Pulmonary Arterial Hypertension (PAH) Characterized by Higher Left Sided Pressures. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Frost AE, Badesch DB, Barst RJ, Benza RL, Elliott CG, Farber H, Krichman A, Liou TG, Raskob GE, Giles S, Feldkircher K, Turner M, McGoon MD. A COMPARISON OF REVEAL REGISTRY DEMOGRAPHIC DATA WITH OTHER/PRIOR REGISTRIES OF PULMONARY ARTERIAL HYPERTENSION (PAH). Chest 2008. [DOI: 10.1378/chest.134.4_meetingabstracts.p134001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Klinger JR, Houtchens J, Thaker S, Hill NS, Farber H. Acute Cardiopulmonary Hemodynamic Effects of Brain Natriuretic Peptide in Patients With Pulmonary Arterial Hypertension. Chest 2005; 128:618S-619S. [PMID: 16373873 DOI: 10.1378/chest.128.6_suppl.618s-a] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- James R Klinger
- Division of Pulmonary and Critical Care Medicine, Rhode Island Hospital, Providence, RI 02903, USA.
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Onishi S, Farber H, Petrucci S. Ultrasonic and dielectric relaxation of lithium perchlorate in 1,2-dimethoxyethane and 1,3-dioxolane at 25.degree.C. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100459a019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Farber H, Petrucci S. Relaxation spectrometry of sodium perchlorate in dimethoxyethane and methyl cellosolve-dimethoxyethane solutions. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j150620a028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Saar D, Brauner J, Farber H, Petrucci S. Dielectric relaxation of some 1:1 electrolytes in tetrahydrofuran and diethyl carbonate. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100506a018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Delsignore M, Farber H, Petrucci S. Molecular relaxation dynamics and ionic association of lithium tetrafluoroborate (LiBF4) in 1,2-dimethoxymethane. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100273a016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Delsignore M, Farber H, Petrucci S. Ionic conductivity and microwave dielectric relaxation of lithium hexafluoroarsenate (LiAsF6) and lithium perchlorate (LiClO4) in dimethyl carbonate. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100269a017] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- C Wittram
- Department of Radiology, Section of Thoracic Radiology, Boston University Medical Center, Atrium 2, 88 E. Newton St., Boston, MA 02118, USA
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Frank RD, Farber H, Stefanidis I, Lanzmich R, Kierdorf HP. Hirudin elimination by hemofiltration: a comparative in vitro study of different membranes. Kidney Int Suppl 1999:S41-5. [PMID: 10560804] [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: 02/14/2023]
Abstract
BACKGROUND Recombinant hirudin (r-hirudin) is a highly specific and selective thrombin inhibitor. Since 1997, it has been approved for the treatment of heparin-induced thrombocytopenia (HIT type II). Renal function impairment drastically prolongs the elimination half-life time. In cases of bleeding or overdosage, there is currently no antidote available. Hemofiltration has been reported to be useful in r-hirudin elimination. In this study, we determined sieving coefficients (SCs) and drug clearances for two different hemofilters currently used in clinical medicine and intensive care. METHODS We developed an in vitro postdilution hemofiltration model using 500 ml heparinized (2 IU unfractionated heparin/ml) fresh human blood and bicarbonate substitution fluid. The investigated membranes were high-flux polysulfone F50 (1.0 m2, Fresenius) and AN69 Nephral 200 (1.05 m2, Hospal Cobe). After equilibration, a bolus of Lepirudin was injected into the postfilter port to achieve a r-hirudin blood level of approximately 15 microg/ml. Serial blood and ultrafiltrate samples were taken for the determination of hirudin levels (chromogenic assay) and control parameters. SC and clearances were calculated according to standard formulae. RESULTS The observed SCs and clearances differed significantly between F50 and Nephral 200 (0.60+/-0.17 and 21.0+/-5.9 ml/min, respectively, vs. 0.44+/-0.09 and 15.5+/-3.0 ml/min, respectively; P = 0.001). The determination of prothrombin fragments showed no coagulation activation during the experiments. The hematocrit values remained stable. CONCLUSIONS Our data show that r-hirudin can be eliminated by hemofiltration. The elimination obviously depends on the membrane material with high-flux polysulfone being more effective than AN69. These findings may be important in cases of overdosage and for r-hirudin dosage guidelines in continuous hemofiltration.
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Affiliation(s)
- R D Frank
- Medizinische Klinik II, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule, Aachen, Germany.
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Farber H, Glauser FL. The effect of oral hydralazine on the pulmonary hemodynamics of patients with pulmonary foreign body granulomatosis. Chest 1982; 82:708-12. [PMID: 7140398 DOI: 10.1378/chest.82.6.708] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Six patients, age 32 +/- 5 yr, had biopsy-proven foreign body granulomatosis secondary to the chronic injection of crushed, suspended pentazocine tablets. All patients complained of exercise-induced dyspnea. Measurements were made of mean pulmonary artery pressures (PAP), cardiac outputs (CO), pulmonary vascular resistance (PVR), and systemic vascular resistance (SVR) at rest and following 9 minutes of steady-state upright exercise. Following this, 50 mg of hydralazine was administered orally. The exercise PAP increased, and exercise PVR following hydralazine rose also. Exercise-induced dyspnea improved in all patients. In patients with foreign body granulomatosis, exercise-induced increases in PAP and PVR are common. This increase in PAP and PVR can be ameliorated somewhat by the acute oral administration of hydralazine. Exercise-induced dyspnea also improves.
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