Effect of transdermal nitroglycerin on inflammatory mediators in patients with peripheral atherosclerotic vascular disease.
OBJECTIVE
To demonstrate that nitroglycerin improves biological markers of arterial inflammation in patients with peripheral vascular disease.


BACKGROUND
Atherosclerosis is an inflammatory disease in which there is an increase in active inflammation markers such as C-reactive protein and other factors released by endothelial cells. Nitroglycerin acts by a chemical liberation of nitric oxide. We have previously published the results from several controlled clinical trials confirming an anti-inflammatory action of nitroglycerin.


METHODS
Forty patients with peripheral vascular disease entered a randomized, double-blind, placebo-controlled pilot study for 6 weeks. Twenty-one patients were treated with continuous application of a transdermal nitroglycerin patch (15 mg/24 hours) on the anterior face of the thigh. Venous blood samples were obtained before treatment and 2 and 6 weeks after. We measured plasma levels of C-reactive protein, cGMP (also intraplatelet cGMP), E-selectin, ICAM, VCAM-1, IL-6, and nitrites/nitrates.


RESULTS
No biological parameter was modified in the placebo group. On the contrary, nitroglycerin significantly reduced plasma levels of C-reactive protein and sE-selectin and increased the levels of intraplatelet cGMP.


CONCLUSIONS
The results of this preliminary study show that nitroglycerin has an anti-inflammatory action in patients with peripheral vascular disease. This may provide a new therapeutic approach to understanding the efficacy of nitrovasodilators in the improvement of atherosclerotic syndromes.
de Berrazueta
José R
JR
Division of Cardiology, Hospital Universitario M de Valdecilla and University of Cantabria, Santander, Spain. jose.berrazueta@unican.es
Sampedro
Isabel
I
Garcia-Unzueta
M Teresa
MT
Llorca
Javier
J
Bustamante
Manuel
M
Amado
Jose A
JA
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000097:blood / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D006152:Cyclic GMP / Q000097:blood; D004311:Double-Blind Method; D019040:E-Selectin / Q000097:blood; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000097:blood; D009573:Nitrites / Q000097:blood; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use*; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000188:drug therapy*; D010865:Pilot Projects; D018709:Statistics, Nonparametric; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D014657:Vasculitis / Q000097:blood / Q000188:drug therapy*; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D019040:E-Selectin; D015850:Interleukin-6; D009566:Nitrates; D009573:Nitrites; D019010:Vascular Cell Adhesion Molecule-1; D014665:Vasodilator Agents; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein; D005996:Nitroglycerin; D006152:Cyclic GMP