Hypoxic pulmonary vasoconstriction (HPV) and
pulmonary hypertension present a common and formidable clinical problem for practicing intensivists, thoracic, transplant, and
trauma surgeons. The Redox Theory for the mechanisms of HPV has provided researchers with a new understanding of the etiology behind HPV that has opened the door to many new avenues of
therapy for the disease.
Potassium channels have been proposed to be the main mediator contributing to HPV, and treatment concepts that attempt to manipulate the function and number of those channels have been explored. Additionally, attempts to transfer genes that express the formation of specific
potassium channels directly into pulmonary hypertensive lungs have proven to be very promising. Finally,
rho kinase (ROK) has been discovered to play a very central role in the formation of
hypoxia-induced
pulmonary hypertension, and the advent of very specific ROK inhibitors has shown positive clinical results. The purposes of this review are to: (1) briefly discuss some of the basic mechanisms that undergird HPV, including the Redox Theory for the mechanisms of HPV; (2) address current research involving treatments concepts related to
ion channels; (3) report on research involving gene therapy to combat
pulmonary hypertension; and (4) examine potential therapeutic avenues associated with inhibition of
rho kinase.