Effect of iloprost on plasma asymmetric dimethylarginine and plasma and platelet serotonin in patients with peripheral arterial occlusive disease

Iloprost, a prostacyclin analogue, is used in the treatment of peripheral arterial occlusive disease at Leriche–Fontaine stages III–IV, through intravenous infusion for at least 21 days. Recently, iloprost has been shown to be safe and effective in critical limb ischemia patients when administered p...

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Bibliographic Details
Published in:Prostaglandins & other lipid mediators 2006-09, Vol.80 (3), p.175-182
Main Authors: Blardi, Patrizia, de Lalla, Arianna, Pieragalli, Daniela, De Franco, Vincenzo, Meini, Simone, Ceccatelli, Linda, Auteri, Alberto
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arginine - analogs & derivatives
Arginine - blood
Arterial Occlusive Diseases - blood
Arterial Occlusive Diseases - complications
Arterial Occlusive Diseases - drug therapy
Asymmetric dimethylarginine
Blood Platelets - chemistry
Blood Platelets - drug effects
Blood Pressure - drug effects
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - complications
Drug Administration Schedule
Exercise Test
Female
Humans
Iloprost
Iloprost - administration & dosage
Iloprost - pharmacology
Iloprost - therapeutic use
Infusions, Intravenous
Male
Peripheral arterial occlusive disease
Peripheral Vascular Diseases - blood
Peripheral Vascular Diseases - complications
Peripheral Vascular Diseases - drug therapy
Platelet Aggregation Inhibitors - administration & dosage
Platelet Aggregation Inhibitors - pharmacology
Platelet Aggregation Inhibitors - therapeutic use
Serotonin
Serotonin - blood
Treatment Outcome
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Summary:Iloprost, a prostacyclin analogue, is used in the treatment of peripheral arterial occlusive disease at Leriche–Fontaine stages III–IV, through intravenous infusion for at least 21 days. Recently, iloprost has been shown to be safe and effective in critical limb ischemia patients when administered per 7 days. We investigated in patients at Leriche–Fontaine stages III–IV the effect of 1-week treatment with iloprost on plasma asymmetric dimethylarginine (ADMA), plasma and platelet serotonin, and on clinical response. Twenty-four critical limb ischemia patients (16 men and 8 women, mean age 76 ± 9.7 years) were included in the study and treated with intravenous iloprost (titrated from 0.5 up to 1.5 ng/kg/min) for 16 h a day for seven consecutive days. Blood samples were drawn before infusion on days 1, 4 and 8 of treatment, under the same conditions. Clinical assessment was performed by clinical evaluation, ankle/brachial pressure index and treadmill exercise test. During treatment with iloprost patients clinically improved and plasma levels of ADMA significantly decreased ( p < 0.001). We also observed a significant increase of serotonin ( p < 0.01) in platelets and a significant decrease of serotonin ( p < 0.001) in plasma. Similar variations of ADMA and serotonin were found in two subgroups of patients, diabetics and non-diabetics. One-week treatment with iloprost in critical limb ischemia patients induced changes of peripheral markers of endothelial dysfunction and atherosclerosis, such as ADMA and serotonin, associated to a clinical improvement.
ISSN:1098-8823
DOI:10.1016/j.prostaglandins.2006.06.005