Epoprostenol therapy decreases elevated circulating levels of monocyte chemoattractant protein-1 in patients with primary pulmonary hypertension.
BACKGROUND
Primary pulmonary hypertension (PPH) is a rare disease characterized by progressively increased resistance of the pulmonary arteries associated with vascular remodeling. Infiltration of inflammatory cells in affected vessels is a common pathological finding. Monocyte chemoattractant protein-1 (MCP-1) is recognized as a potent chemotactic and activating factor for monocytes and leukocytes, but its significance in PPH is unclear.


RESULTS
Serum MCP-1 concentrations were measured in 16 PPH patients and the results were compared with those in 16 normal controls. MCP-1 concentrations in PPH patients (265.6+/-29.5 pg/ml) were significantly elevated compared with those in normal controls (119.6+/-6.9 pg/ml, p<0.0001). In 9 patients (3 men, 6 women; mean age, 29+/-3 years), repeated MCP-1 and hemodynamic measurements were performed prior to and during intravenous epoprostenol therapy. During a mean follow-up period of 7+/-1 months, MCP-1 concentrations were significantly reduced (288.8+/-122.8 to 185.9+/-117.5 pg/ml, p<0.01).


CONCLUSIONS
Circulating MCP-1 concentrations are increased in PPH patients, but can alleviated by chronic intravenous epoprostenol therapy. The increase in MCP-1 might be one of the important factors responsible for the disease development in patients with PPH.
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine and Dentistry, Japan. khashi@cc.okayama-u.ac.jp
Hashimoto
H
Katsushi
Nakamura
N
Kazufumi
Fujio
F
Hideki
Miyaji
M
Katsumasa
Morita
M
Hiroshi
Kusano
K
Kengo
Date
D
Hiroshi
Shimizu
S
Nobuyoshi
Emori
E
Tetsuro
Matsubara
M
Hiromi
Ohe
O
Tohru
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001783:Blood Flow Velocity; D054407:Chemokine CCL4; D011464:Epoprostenol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D019402:Macrophage Inflammatory Proteins / Q000097:blood*; D008297:Male; D011651:Pulmonary Artery / Q000503:physiopathology; D014655:Vascular Resistance
D000959:Antihypertensive Agents; D054407:Chemokine CCL4; D019402:Macrophage Inflammatory Proteins; D011464:Epoprostenol