Sarpogrelate hydrochloride, a selective 5-hydroxytryptamine(2A) antagonist, augments autologous bone marrow mononuclear cell implantation-induced improvement in endothelium-dependent vasodilation in patients with critical limb ischemia.

Abstract

BACKGROUND:

The purpose of this study was to determine the effect of a combination of bone marrow mononuclear cell (BM-MNC) implantation and sarpogrelate, a selective 5-HT(2A) antagonist, on endothelial function in patients with critical limb ischemia (CLI).

METHODS:

We evaluated the leg blood flow (LBF) responses to acetylcholine (ACh) and sodium nitroprusside before and after BM-MNC implantation in 16 patients with CLI. We divided patients with CLI into 2 groups: those cotreated with sarpogrelate orally for 12 weeks (sarpogrelate group, n = 8) and those who remained on conventional therapy (control group, n = 8). LBF was measured by strain gauge plethysmography.

RESULTS:

BM-MNC implantation improved ankle brachial pressure index, transcutaneous oxygen pressure, and pain-free walking time. There was no significant difference in these parameters between the 2 groups. Before BM-MNC implantation, LBF responses to ACh were similar in the sarpogrelate group and control group. Twelve weeks of BM-MNC implantation enhanced LBF responses to ACh in the sarpogrelate and control groups. After 12 weeks of BM-MNC implantation, LBF response to ACh was significantly greater in the sarpogrelate group than in the control group. BM-MNC implantation did not alter the LBF responses to sodium nitroprusside in either group.

CONCLUSIONS:

These findings suggest that BM-MNC implantation improved not only limb ischemic symptoms but also endothelium-dependent vasodilation in patients with CLI. A combination of BM-MNC implantation and sarpogrelate had a more beneficial effect on vascular function in these patients.

• Authors: Yukihito Higashi, Masanori Miyazaki, Chikara Goto, Hiroaki Sanada, Taijiro Sueda, Kazuaki Chayama
• Journal: Journal of cardiovascular pharmacology (J Cardiovasc Pharmacol) Vol. 55 Issue 1 Pg. 56-61 (Jan 2010) ISSN: 1533-4023 [Electronic] United States
• PMID: 19834330 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Serotonin 5-HT2 Receptor Antagonists
• Serotonin Antagonists
• Succinates
• Vasodilator Agents
• Nitroprusside
• sarpogrelate
• Acetylcholine

Topics

• Acetylcholine (pharmacology)
• Aged
• Bone Marrow Transplantation (methods)
• Combined Modality Therapy
• Endothelium, Vascular (drug effects, physiopathology)
• Female
• Follow-Up Studies
• Humans
• Ischemia (physiopathology, therapy)
• Leg (blood supply)
• Male
• Middle Aged
• Nitroprusside (pharmacology)
• Serotonin 5-HT2 Receptor Antagonists
• Serotonin Antagonists (pharmacology)
• Succinates (pharmacology)
• Transplantation, Autologous
• Vasodilator Agents (pharmacology)