Increased endogenous nitric oxide production induced by physical exercise in peripheral arterial occlusive disease patients.
The effects of 14-day physical exercise or iloprost treatment (0.5-2 ng/Kg/min) on endogenous nitric oxide production and neutrophil adhesion were evaluated in 20 patients with peripheral arterial occlusive disease (Fontaine Stage II). Peripheral venous blood samples and 4-h urine samples were collected before, immediately after 14 days of therapy and 7-10 days after therapy in order to evaluate neutrophil adhesion, nitrite/nitrate and cGMP excretion rates. A longer pain free walking distance was observed after exercise, compared to iloprost (>500 m in 3/10 subjects). Urinary nitrite/nitrate, as well as cGMP concentrations, significantly increased after exercise. Nitrite/nitrate excretion rate inversely correlated to neutrophil adhesion. No variations were observed in these parameters in iloprost treated patients. The improvement in claudication and the transient increase in urinary nitrite/nitrate suggest a possible nitric oxide-dependent mechanism for the clinical efficacy of physical exercise. The results from the present and previous observations indicate that, besides pharmacological treatments, a regular aerobic exercise improves peripheral arterial occlusive disease.
Arosio
E
E
Division of Vascular Medicine and Rehabilitation, University of Verona, Italy.
Cuzzolin
L
L
De Marchi
S
S
Minuz
P
P
Degan
M
M
Crivellente
F
F
Zannoni
M
M
Benoni
G
G
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000378:metabolism* / Q000503:physiopathology* / Q000628:therapy; D002448:Cell Adhesion / Q000187:drug effects; D005081:Exercise Therapy; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use; D007262:Infusions, Intravenous; D008875:Middle Aged; D018375:Neutrophil Activation / Q000187:drug effects; D009504:Neutrophils / Q000187:drug effects; D009566:Nitrates / Q000652:urine; D009569:Nitric Oxide / Q000096:biosynthesis* / Q000378:metabolism; D009573:Nitrites / Q000652:urine; D016491:Peripheral Vascular Diseases / Q000378:metabolism* / Q000503:physiopathology* / Q000628:therapy; D014665:Vasodilator Agents / Q000627:therapeutic use
D009566:Nitrates; D009573:Nitrites; D014665:Vasodilator Agents; D009569:Nitric Oxide; D016285:Iloprost