NEW AND EXPERIMENTAL THERAPIES FOR PULMONARY HYPERTENSION
Section snippets
ENDOTHELIAL MEDIATORS
The pulmonary arterial endothelium produces a variety of active mediators that, under normal conditions, tightly regulate pulmonary vascular tone and control smooth muscle cell proliferation, maintaining the pulmonary vasculature in a low-pressure state. These “good” mediators include nitric oxide, prostacyclin, and heparin-like mediators. On the “bad” side are mediators favoring pulmonary vasoconstriction and cell proliferation, including endothelin-1, thromboxane, and serotonin.
There is now
SUMMARY
Advances in the understanding of the molecular and cellular pathogeneses of PPH have led clinicians beyond simple pulmonary vasodilation as the only treatment for PPH and to a realization that what were previously believed to be irreversible vascular lesions may, in fact, be reversible. The development of agents that target the known endothelial and nonendothelial defects in patients with PPH is well underway. Clinicians are witnessing an exciting new era for physicians and patients dealing
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Address reprint requests to Richard N. Channick, MD, UCSD Medical Center, 9300 Campus Point Dr., La Jolla, CA 92037