Inhaled therapies targeting prostacyclin pathway in pulmonary hypertension due to COPD: systematic review

Alqarni, Abdullah A.; Aldhahir, Abdulelah M.; Bintalib, Heba M.; Alqahtani, Jaber S.; Siraj, Rayan A.; Majrshi, Mansour; AlGarni, Abdulkareem A.; Naser, Abdallah Y.; Alghamdi, Sara A.; Alwafi, Hassan

doi:10.3389/fmed.2023.1217156

Cited by 3 publications

(1 citation statement)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Inhaled treprostinil is the first approved therapy for patients with group 3 PH (only due to interstitial lung disease) as it improves exercise capacity ( 86 ). Our recent systematic review demonstrated that inhaled therapies targeting prostacyclin pathway can reduce pulmonary vascular resistance without worsening pulmonary gas exchange ( 87 ). Although the use inhaled nitric oxide is not currently approved for adults with all forma of PH, limited studies assessed the short-term efficacy of using inhaled nitric oxide in patents with PH due to COPD and demonstrated potential benefits in improving hemodynamic parameters in COPD ( 88 , 89 ).…”

Section: Imbalanced Vasoactive Gene Expression and Mediator Release I...mentioning

confidence: 99%

Role of prostanoids, nitric oxide and endothelin pathways in pulmonary hypertension due to COPD

Alqarni,

Aldhahir,

Alghamdi

et al. 2023

Front. Med.

Self Cite

View full text Add to dashboard Cite

Pulmonary hypertension (PH) due to chronic obstructive pulmonary disease (COPD) is classified as Group 3 PH, with no current proven targeted therapies. Studies suggest that cigarette smoke, the most risk factor for COPD can cause vascular remodelling and eventually PH as a result of dysfunction and proliferation of pulmonary artery smooth muscle cells (PASMCs) and pulmonary artery endothelial cells (PAECs). In addition, hypoxia is a known driver of pulmonary vascular remodelling in COPD, and it is also thought that the presence of hypoxia in patients with COPD may further exaggerate cigarette smoke-induced vascular remodelling; however, the underlying cause is not fully understood. Three main pathways (prostanoids, nitric oxide and endothelin) are currently used as a therapeutic target for the treatment of patients with different groups of PH. However, drugs targeting these three pathways are not approved for patients with COPD-associated PH due to lack of evidence. Thus, this review aims to shed light on the role of impaired prostanoids, nitric oxide and endothelin pathways in cigarette smoke- and hypoxia-induced pulmonary vascular remodelling and also discusses the potential of using these pathways as therapeutic target for patients with PH secondary to COPD.

show abstract

Section: Imbalanced Vasoactive Gene Expression and Mediator Release I...mentioning

confidence: 99%

Role of prostanoids, nitric oxide and endothelin pathways in pulmonary hypertension due to COPD

Alqarni,

Aldhahir,

Alghamdi

et al. 2023

Front. Med.

Self Cite

View full text Add to dashboard Cite

show abstract

Pulmonary hypertension in chronic obstructive pulmonary disease: current understanding, knowledge gaps and future directions

Atchley,

Kakkera

2023

Current Opinion in Pulmonary Medicine

View full text Add to dashboard Cite

Purpose of review Despite the advent of effective and mechanistically diverse treatments for pulmonary arterial hypertension (PAH) and their positive impacts on the functional capacities and outcomes for PAH patients, the much larger population of patients with pulmonary hypertension (PH) in chronic lung diseases like chronic obstructive pulmonary disease (PH-COPD) remain without effective therapies. Recent findings In this review, we will highlight advances in the understanding of PH-COPD pathobiology, the clinical impact comorbid PH has on COPD outcomes, and detail the spectrum of disease and clinical phenotypes that encompass the heterogenous disease manifestations of PH-COPD. Finally, we will examine recent studies exploring the effects of potential treatments for PH-COPD and highlight sub-populations and treatment options that warrant further study. Summary As the PAH population-base ages and comorbid diseases become more frequently diagnosed in PAH patients, the need to clearly delineate subpopulations for clinical applications of PH therapies and research becomes even more urgent. Through an improved understanding of the clinical phenotypes of PH-COPD and the overlap with certain subpopulations of PAH, a framework for future research and potential for therapeutic impact is highlighted.

show abstract

Activity-related dyspnea and exercise intolerance in chronic obstructive pulmonary disease: recent insights

James,

Berton,

Neder

2024

Current Opinion in Pulmonary Medicine

View full text Add to dashboard Cite

Purpose of review Exertional dyspnea and exercise intolerance remain key patient-related outcomes in chronic obstructive pulmonary disease (COPD). Improvement in treatment strategies is pendant further understand of their underpinnings across the spectrum of disease severity. Recent findings Emerging literature has been reviewed based on a conceptual framework that relates ventilatory demand to capacity under the modulating influence of sub-cortical and cortical centers (symptom perception and affective interpretation). Evidence supporting these fundamental tenets is critically appraised, focusing on mechanistic and interventional studies that shed novel light on the sources of heightened and/or mechanically constrained ventilation. Mechanistic studies using proxies of the inspiratory neural drive (e.g., diaphragm electromyography) were particularly informative, as well as interventional trials aimed at decreasing afferent stimulation and/or symptom perception via pharmacological (e.g., low-dose opiates in selected patients, high flow oxygen, oral nitrate) and nonpharmacological (e.g., novel exercise training paradigms, inspiratory muscle training, breathing techniques) interventions. Summary Therapeutic and rehabilitative strategies to lessen dyspnea's devastating impact on quality of life should minimize demand in the setting of reduced capacity and increased sensation awareness in COPD. The most successful attempts so far have amalgamated pharmacological and nonpharmacological approaches tailored to the main underlying mechanisms on an individual basis.

show abstract

Inhaled therapies targeting prostacyclin pathway in pulmonary hypertension due to COPD: systematic review

Cited by 3 publications

References 44 publications

Role of prostanoids, nitric oxide and endothelin pathways in pulmonary hypertension due to COPD

Role of prostanoids, nitric oxide and endothelin pathways in pulmonary hypertension due to COPD

Pulmonary hypertension in chronic obstructive pulmonary disease: current understanding, knowledge gaps and future directions

Activity-related dyspnea and exercise intolerance in chronic obstructive pulmonary disease: recent insights

Contact Info

Product

Resources

About