Effects of prostaglandin E1alpha cyclodextrin [corrected] treatment on endothelial dysfunction in patients with systemic sclerosis.
OBJECTIVE
Systemic sclerosis (SSc) is characterized by an altered nitric oxide (NO): endothelin I ratio and by endothelial dysfunction.


OBJECTIVE
To verify the effects of prostaglandin E1 (PGE1) alpha-cyclodestrin treatment on endothelial function, quantified as flow-mediated dilation (FMD) of the radial artery.


METHODS
In 16 women with SSc (age 57 +/- 2.7 years, means +/- SE) in whom a diagnosis of SSc had been made several years earlier (7.1 +/- 1.2 years), FMD was evaluated by an echotracking technique on the radial artery, using trinitroglycerin vasodilation as a non-endothelial measure of the vessel's ability to increase its diameter maximally. FMD was evaluated after 4 months washout period and after 4 months cyclic infusion of PGE1 alpha-cyclodestrin. Expired NO was measured at the same time.


RESULTS
PGE1 alpha-cyclodestrin cyclic infusions did not modify systolic and diastolic blood pressure, heart rate or trinitroglycerin radial artery vasodilation. On the other hand, it induced a marked and significant increase in FMD of the radial artery, which was also accompanied by an increase in blood flow and expired NO.


CONCLUSIONS
Endothelial dysfunction and reduced FMD associated with SSc are improved by cyclic treatment with PGE1 alpha-cyclodestrin. This effect occurs together with a concomitant increase in expired NO, suggesting its direct positive influence on endothelial function. It may also partly explain the clinical beneficial effect of the drug in SSc.
Giannattasio
Cristina
C
Clinica Medica, Milan, Università Milano-Bicocca and S. Gerardo Hospital, Monza (Milan), Italy.
Pozzi
MariaRosa
M
Gardinali
Marco
M
Gradinali
Marco
M
Montemerlo
Elisabetta
E
Citterio
Francesca
F
Maestroni
Silvia
S
Fantini
Elena
E
Failla
Monica
M
Robuschi
Maria
M
Bianco
Salvatore
S
Mancia
Giuseppe
G
D000527:Alprostadil / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000704:Analysis of Variance; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology*; D045853:Exhalation; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis; D017534:Radial Artery / Q000187:drug effects* / Q000503:physiopathology; D012039:Regional Blood Flow / Q000187:drug effects; D012595:Scleroderma, Systemic / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology*; D016896:Treatment Outcome; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000627:therapeutic use; D047391:alpha-Cyclodextrins / Q000627:therapeutic use*
D014665:Vasodilator Agents; D047391:alpha-Cyclodextrins; C043214:prostaglandin E1-alpha-cyclodextrin; D009569:Nitric Oxide; D000527:Alprostadil