Prostacyclin for Pulmonary Hypertension

PGI2 as a regulator of CD4+ subset differentiation and function

“…Upon binding IP expressed on endothelial cells, PGI 2 modulates relaxation of vascular smooth muscle and vasodilation of vascular beds. Due to these effects on the vascular system, in the early 1980s PGI 2 was first used successfully in the treatment of pulmonary hypertension [5]. …”

Effect of prostacyclin on vascular capacity in the dog.

“…This vasodilating action has therapeutic potential. For example, beneficial effects of PGI2 have been demonstrated in patients with pulmonary hypertension (11)(12)(13)(14), peripheral ischemic vascular disease (15)(16)(17)(18)(19), and unstable angina (20). Furthermore, the increase in tissue conductance, which is the reciprocal ofvascular resistance, particularly in the splanchnic circulation, coupled with the augmentation of cardiac output, which has been established experimentally, provides rationale for the use of PGI2 in the management of congestive heart failure (21).…”

Side effects occurring during administration of epoprostenol (prostacyclin, PGI2), in man.

“…A role is established in extracorporeal circulations, such as cardiopulmonary bypass Radegran & Papaconstantinou, 1980;Walker et al, 1981), charcoal haemoperfusion and haemodialysis (Tumey et al, 1980;Zusman et al, 1981a). However, other potential applications for this compound include peripheral arterial disease (Hossman et al, 1981;Olsson, 1980;Machin et al, 1981a;Pardy et al, 1980), acute or chronic coronary artery insufficiency (Bergman et al, 1981;Szczeklik et al, 1980e), haemolytic-uraemic syndrome (Beattie et al, 1981;Webster et al, 1981), thrombotic thrombocytopenic purpura (FitzGerald et al, 1981), hypertension, especially in pregnancy (Fidler et al, 1981) and also pulmonary hypertension (Szczeklik et al, 1980c), Raynaud's disorder (Belch et al, 1981;Dowd et al, 1982) and persistent foetal circulation (Lock et al, 1979). From knowledge of its potent action as a platelet inhibitor and as a vasodilator, activity in an even wider range of disorders could be predicted, and is currently being investigated.…”