Treprostinil Iontophoresis in Idiopathic Pulmonary Arterial Hypertension

Tonelli, Adriano R.; Ahmed, Mostafa; Alkukhun, Laith; Cikach, Frank; Aulak, Kulwant S.; Dweik, Raed A.

doi:10.1164/rccm.201506-1091le

Cited by 13 publications

(17 citation statements)

References 12 publications

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“…One of the studies that was performed by our group showed that patients with idiopathic PAH and SSc‐PAH had lower blood flow index and greater vascular tortuosity in sublingual microcirculation compared to healthy controls by sublingual capillaroscopy, suggesting a systemic vascular dysfunction in both conditions . Morphological clues detected with capillaroscopy in this study lead to another study performed by our group which showed that patients with idiopathic PAH also had decreased vasodilatory response to treprostinil iontophoresis by laser Doppler flowmetry . Therefore, we strongly believe that NC and laser Doppler techniques can be used together to complement each other in morphologic and functional evaluation of microcirculation and iontophoresis of vasoactive medications may be a promising tool in SSc‐PAH to help to predict the response to specific PAH medications without associated systemic side effects.…”

Section: Methods To Detect Microvascular Changes In Ssc and Slesupporting

confidence: 58%

Microvascular involvement in systemic sclerosis and systemic lupus erythematosus

2019

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Microvascular changes play central roles in the pathophysiology of systemic sclerosis (SSc) and systemic lupus erythematosus (SLE), and represent major causes of morbidity and mortality in these patients. Therefore, clinical tools that can assess the microvasculature are of great importance both at the time of diagnosis and follow up of these cases. These tools include capillaroscopy, laser imaging techniques, infrared thermography and iontophoresis. In this review, we examined the clinical manifestations and pathobiology of microvascular involvement in SSc and SLE as well as the methodologies used to evaluate the microvasculature. This article is protected by copyright. All rights reserved.

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Section: Methods To Detect Microvascular Changes In Ssc and Slesupporting

confidence: 58%

Microvascular involvement in systemic sclerosis and systemic lupus erythematosus

2019

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“…We measured the subjects’ heart rate, blood pressure, and pulse oxygen saturation. We carefully prepped the skin of the anterior aspect of the forearm, 5 cm distal to the antecubital fossa and away from visible veins or skin abrasion [52]. Great care was taken to create similar experimental conditions to ensure regional and temporal reproducibility.…”

Section: Methodsmentioning

confidence: 99%

“…Iontophoresis was performed using the thermostatic probe PF 481, the periIont micropharmacology system, the drug delivery electrodes PF 383 and the dispersive electrodes PF 384 (Perimed, Järfälla, Sweden) [52]. At different skin sites, we placed 180 μL of either acetylcholine 1% (Sigma-Aldrich, St Louis, MO, USA) or sodium nitroprusside 1% (Marathon Pharmaceuticals, LLC, Northbrook, IL, USA) in the sponge of the drug-delivery electrode.…”

Section: Methodsmentioning

confidence: 99%

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A pilot study on the kinetics of metabolites and microvascular cutaneous effects of nitric oxide inhalation in healthy volunteers

et al. 2019

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Rationale Inhaled nitric oxide (NO) exerts a variety of effects through metabolites and these play an important role in regulation of hemodynamics in the body. A detailed investigation into the generation of these metabolites has been overlooked. Objectives We investigated the kinetics of nitrite and S-nitrosothiol-hemoglobin (SNO-Hb) in plasma derived from inhaled NO subjects and how this modifies the cutaneous microvascular response. Findings We enrolled 15 healthy volunteers. Plasma nitrite levels at baseline and during NO inhalation (15 minutes at 40 ppm) were 102 (86–118) and 114 (87–129) nM, respectively. The nitrite peak occurred at 5 minutes of discontinuing NO (131 (104–170) nM). Plasma nitrate levels were not significantly different during the study. SNO-Hb molar ratio levels at baseline and during NO inhalation were 4.7E-3 (2.5E-3–5.8E-3) and 7.8E-3 (4.1E-3-13.0E-3), respectively. Levels of SNO-Hb continued to climb up to the last study time point (30 min: 10.6E-3 (5.3E-3-15.5E-3)). The response to acetylcholine iontophoresis both before and during NO inhalation was inversely associated with the SNO-Hb level (r: -0.57, p = 0.03, and r: -0.54, p = 0.04, respectively). Conclusions Both nitrite and SNO-Hb increase during NO inhalation. Nitrite increases first, followed by a more sustained increase in Hb-SNO. Nitrite and Hb-SNO could be a mobile reservoir of NO with potential implications on the systemic microvasculature.

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“…The current approach to treatment does not take into account recent and ongoing advances in genomics, metabolomics, imaging, etc. (4)(5)(6)(7)(8)(9)(10)(11).…”

Section: Pulmonary Hypertension and Precision Medicine Through The "Omentioning

confidence: 99%

Pulmonary Hypertension and Precision Medicine through the “Omics” Looking Glass

Barnes

Dweik

2017

Am J Respir Crit Care Med

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Noninvasive staging of non-small cell lung cancer: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest 2007;132:178S-201S. 4. Silvestri GA, Gonzalez AV, Jantz MA, Margolis ML, Gould MK, Tanoue LT, Harris LJ, Detterbeck FC. Methods for staging non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013;143:e211S-250S. 5. Gould MK, Kuschner WG, Rydzak CE, Maclean CC, Demas AN, Shigemitsu H, Chan JK, Owens DK. Test performance of positron emission tomography and computed tomography for mediastinal staging in patients with non-small-cell lung cancer: a meta-analysis. Ann Intern Med 2003;139:879-892. 6. Shafazand S, Gould MK. A clinical prediction rule to estimate the probability of mediastinal metastasis in patients with non-small cell lung cancer.

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Treprostinil Iontophoresis in Idiopathic Pulmonary Arterial Hypertension

Cited by 13 publications

References 12 publications

Microvascular involvement in systemic sclerosis and systemic lupus erythematosus

Microvascular involvement in systemic sclerosis and systemic lupus erythematosus

A pilot study on the kinetics of metabolites and microvascular cutaneous effects of nitric oxide inhalation in healthy volunteers

Pulmonary Hypertension and Precision Medicine through the “Omics” Looking Glass

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