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

Abstract

BACKGROUND:

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.

METHODS AND RESULTS:

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.

CONCLUSIONS:

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.

• Authors: Patrizia Blardi, Arianna de Lalla, Daniela Pieragalli, Vincenzo De Franco, Simone Meini, Linda Ceccatelli, Alberto Auteri
• Journal: Prostaglandins & other lipid mediators (Prostaglandins Other Lipid Mediat) Vol. 80 Issue 3-4 Pg. 175-82 (Sep 2006) ISSN: 1098-8823 [Print] United States
• PMID: 16939882 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Platelet Aggregation Inhibitors
• Serotonin
• N,N-dimethylarginine
• Arginine
• Iloprost

Topics

• Aged
• Aged, 80 and over
• Arginine (analogs & derivatives, blood)
• Arterial Occlusive Diseases (blood, complications, drug therapy)
• Blood Platelets (chemistry, drug effects)
• Blood Pressure (drug effects)
• Diabetes Mellitus, Type 2 (blood, complications)
• Drug Administration Schedule
• Exercise Test
• Female
• Humans
• Iloprost (administration & dosage, pharmacology, therapeutic use)
• Infusions, Intravenous
• Male
• Peripheral Vascular Diseases (blood, complications, drug therapy)
• Platelet Aggregation Inhibitors (administration & dosage, pharmacology, therapeutic use)
• Serotonin (blood)
• Treatment Outcome