文章基本信息

标题：Epoprostenol sodium for treatment of pulmonary arterial hypertension
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作者：Yukihiro Saito ; Kazufumi Nakamura ; Satoshi Akagi 等
期刊名称：Vascular Health and Risk Management
印刷版ISSN：1176-6344
电子版ISSN：1178-2048
出版年度：2015
卷号：11
页码：265-270
DOI：10.2147/VHRM.S50368
出版社：Dove Medical Press Ltd
摘要：The release of endogenous prostacyclin (PGI₂) is depressed in patients with pulmonary arterial hypertension (PAH). PGI₂ replacement therapy by epoprostenol infusion is one of the best treatments available for PAH. Here, we provide an overview of the current clinical data for epoprostenol. Epoprostenol treatment improves symptoms, exercise capacity, and hemodynamics, and is the only treatment that has been shown to reduce mortality in patients with idiopathic PAH (IPAH) in randomized clinical trials. We have reported that high-dose epoprostenol therapy (>40 ng/kg/min) also results in marked hemodynamic improvement in some patients with IPAH. High-dose epoprostenol has a pro-apoptotic effect on PAH-PASMCs via the IP receptor and upregulation of Fas ligand (FasL) in vitro. However, long-term intravenous administration of epoprostenol is sometimes associated with catheter-related infections and leads to considerable inconvenience for the patient. In the future, the development of new routes of administration or the development of powerful PGI₂ analogs, IP-receptor agonists, and gene and cell-based therapy enhancing PGI₂ production with new routes of administration is required.
关键词：pulmonary arterial hypertension; prostacyclin; apoptosis