阿魏酸钠对野百合碱诱导肺动脉高压大鼠的保护作用
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的:肺动脉高压(pulmonary arterial hypertension,PAH)是指以肺血管阻力进行性增高,并导致右心室衰竭及死亡为特征的一组疾病。内皮功能障碍是肺动脉高压的核心病理生理改变,引起内皮和平滑肌细胞过度增殖导致管腔狭窄。既往研究表明阿魏酸钠有抗血栓、抗血小板聚集和抗氧化的作用,阿魏酸钠能够通过增加血管NO生成而改善内皮功能。有临床经验表明阿魏酸钠对于慢性阻塞性肺病及肺心病有一定的疗效,但阿魏酸钠对肺动脉高压是否有保护作用还不明确。故我们通过野百合碱建立肺动脉高压大鼠模型,验证其是否有保护作用。
     方法:共50只Sprague-Dawley雄性大鼠被随机分为4组接受不同的处理,正常对照组(n=8):第一日皮下注射生理盐水2ml/Kg,第2—35天每日一次蒸馏水2ml/Kg灌胃;.阳性对照组(n=12):第1天腹腔注射野百合碱60 mg/kg,第2—35天每日一次蒸馏水2ml/Kg灌胃;预防组(n=15):室内饲养,第1天腹腔注射野百合碱60 mg/kg,第2—35天每日一次阿魏酸钠0.3g/Kg灌胃;.治疗组(n=15):第1天腹腔注射野百合碱60 mg/kg,第2—21天每日一次蒸馏水2ml/Kg灌胃;第22—35天每日一次阿魏酸钠0.3g/Kg灌胃。
     在第35天时,在麻醉状态下右心导管法,测定大鼠的血流动力学指标,右室收缩压、颈动脉平均压、心率,留取血标本测定血浆ET-1水平,处死大鼠后取心脏,测定右室/(左室+室间隔)重量之比,留取肺组织作Western Blot测定内皮型一氧化氮合酶eNOS的在大鼠肺组织中的表达改变,以及作肺血管病理学切片,观察肺血管的病理变化,并测定血管中膜厚度。
     结果:在注射野百合碱35天后,所有8只正常对照均存活(100%,8/8),阳性对照组有7只存活(生存率46.7%,7/15),预防组有8只存活(生存率66.7%,8/12),治疗组有8只存活(生存率53.3%,8/15),大鼠死因均为右心衰竭,大鼠的生存率无统计学差异。与阳性对照组相比,阿魏酸钠显著降低预防组的右室收缩压(77.0? 0.8 vs.59.5?.1mmHg),心率和动脉血压无显著变化,降低了预防组右室/(左室+室间隔)重量之比(0.697.10 vs.0.487.10,p<0.05),减轻了预防组大鼠的肺血管内膜的增殖,显著降低血管中膜厚度(11.57.5 vs.9.17.4,p<0.05),但血浆ET-1水平在预防和治疗组均仅有降低趋势,无统计学差异。阿魏酸钠使预防组和治疗组的eNOS表达,均较阳性对照组显著恢复(0.56? 0.2 vs.41.21?0.59Vs.1.13 ? 0.50,p<0.05)。
     结论:阿魏酸钠对野百合碱诱导肺动脉高压大鼠有一定保护作用,能改善血流动力学指标,降低其右室收缩压,降低右心室负荷,降低右室/(左室+室间隔)重量之比,其机制可能与eNOS表达恢复相关。
Background:Pulmonary arterial hypertension is a fatal disorder that is associated with remodeling of the pulmonary vasculature.Endothelial dysfunction plays an important role in the progression of pulmonary arterial hypertension.Previous studies showed that sodium ferulate can improve endothelial function by increasing nitric oxide(NO) production.Sodium ferulate has antithrombotic,platelet aggregation inhibitory and antioxidant activities.We hypothesized that daily supplemenation of sodium ferulate attenuate monocrotaline induced pulmonary artery hypertension in rats.
     Methods:Our hypotheses was tested in a modle of pulmonary arterial hypertension induced with monocrotaline in rats.Fifty rats were randomly divided into four groups: normal control(treated with saline and distilled water,n=8 ),other rats received monocrotaline injection were randomly assigned to preventive group(treated with sodium ferulate,n=12),positive control group(treated with distilled water,n=15) and treatment group(treated with distilled water then with sodium ferulate,n=15).We measuered the right ventricular systolic pressure,the ratio of right ventricular weight to weight of the left ventricle plus septum.We investigated the changes in the expression of endothelial nitric oxide synthase(eNOS) in lung and endothelin-1 (ET-1) level in plasma,as well as the histological changes in pulmonary arteries in the different groups.
     Result:Up to the day 35,pulmonary arterial hypertension was successful developed in the positive control group rats.Compared with positive control group,sodium ferulate significantly reduced right ventricle systolic pressure(77.0? 0.8 vs. 59.5?.1mmHg,p<0.05) and the ratio of right ventricular weight to weight of the left ventricle plus septum in the preventive group(0.68?.10 vs.0.48?.10,p<0.05). Sodium ferulate significantly restored the expression of eNOS in lung in the preventive and reversal groups.However,sodium ferulate didn't significantly reduce the plasma ET-1 level in the preventive and reversal groups.
     Conclusion:sodium ferulate attenuated pulmonary arterial hypertension in the monocrotaline-treated rats.The protective effects may be associated with the restoration of expression of eNOS expression.
引文
1.D AG,Barst RJ,Ayres SM,Bergofsky EH,Brundage BH,Detre KM,et al.Survival in patients with primary pulmonary hypertension.Results from a national prospective registry.Ann Intern Med 1991,115:343-349.
    2.Deng Z,Morse JH,Slager SL,Cuervo N,Moore K J,Venetos G,et al.Familial primary pulmonary hypertension(gene PPH1) is caused by mutations in the bone morphogenetic protein receptor-Ⅱ gene.Am J Hum Genet 2000,67:737-744.
    3.Galie N,Torbicki A,Barst R,Dartevelle P,Haworth S,Higenbottam T,et al.Guidelines on diagnosis and treatment of pulmonary arterial hypertension.The Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology.Eur Heart J 2004,25:2243-2278.
    4.Benedict N,Seybert A,Mathier MA.Evidence-based pharmacologic management of pulmonary arterial hypertension.Clin Ther 2007,29:2134-2153.
    5.Wang BH,Ou-Yang JP.Pharmacological actions of sodium ferulate in cardiovascular system.Cardiovasc Drug Rev 2005,23:161 - 172.
    6.林迎晖,陈文为.阿魏酸钠的药理作用及分子改造前景.药学学报1994,29:717-720.
    7 王烨,薛全福,汗澍淮,等.阿魏酸钠对缺氧性肺动脉高压大鼠血小板聚集率和血浆TXB2及6-keto-PGFla的影响。昆明医学院学报,1992,13(3):29-32.
    8.吴东方,彭仁霸.阿魏酸钠抗溴苯实验性肝损害作用机制的探讨。中国药学杂志,1995,30(10):597-9
    9.李友清,谭秀娟,徐启明,蔡宏伟,郭曲练.阿魏酸钠对犬心脏停跳复苏后脑组织TXB2、6-keto-PGF1 α及MDA含量的影响.中华麻醉学杂志1995.15:387-390.
    10.丁虹,彭仁霸,张卫国,等.对乙酰氨基酚对小鼠原代培养肝细咆的损伤及阿魏酸钠保护作用的研究。中国药学杂志,1997,32(4):210-4
    11.吴东方,彭仁霸,汪晖.阿魏酸钠部分减轻氢化泼尼讼引起的小鼠肝脏毒性[J].药学学报,199530(11):801-3
    12.汪晖,彭仁,王若琨,等.阿魏酸钠对乙醇所致小鼠肝脏抗氧化功能改变的拮抗作用.药学学报,1997,32(7):511-4.
    13.李颖,彭仁珏.阿魏酸钠和当归醇沉物对免疫性肝损伤的干预作用EJ].中草药,2000,31(41:274-7.
    14.卢基贵,王伟,陈文为;用气相色谱研究抗氧化剂对膜脂肪酸的保护作用[J];药学学报,1991;26:406-410
    15.陆怡,许彩民,杨洋,潘华珍;阿魏酸钠对氧化诱导人淋巴细胞凋亡的抑制作用中国医学科学院学报 1998;20:44-48。
    16.句海松,李小洁,赵保路,等.阿魏酸钠和18β-甘草次酸对氧自由基的清除作用.中国药理学报,1990,11:466-470.
    17.廖长秀,汪晖,彭仁,等.阿魏酸钠对甘油致小鼠肾脏氧化性损伤的拮抗效应.药学学报,2003,38(12):900-903
    18.Zhang WG,Zhang ZS,Yu XG,Yang DZ.Protective effect of natrii ferulatis on myocardial ischemia reperfusion injury in rats.J Hubei Med Coll China 1992;13:217-219(in Chinese).
    19.Wang B,Ouyang J,Liu Y,Yang J,Wei L,Li K,Yang H.Sodium ferulate inhibits atherosclerogenesis in hyperlipidemia rabbits.J Cardiovasc Pharmacol 2004,43:549-554.
    20.喻红,洪嘉玲,吴东方.阿魏酸钠对氧化LDL所致兔主动脉平滑肌细咆增殖的影响.中国中药杂志,1999,24(6):365-8
    21.Traore M,Hong JL,Xu CL.Influence of angelicae sinensis extract on lipid accumulation in rabbit aortic smooth muscle cells induced by oxidized LDL.Biorheology 2003;40:389-394.
    22.Wang F,Wang JY,Li F,et al.Antagonism effects of caffeic acid,ferulic acids and CA-1201 on ET-1 biological responses.Chin J Pathophysiol 1999;15:688-691
    23.Wang RL,Yang XQ,Wang Y,Zhou XM,Hu XL.Effect of sodium ferulate on pulmonary artery pressure,plasma endothelin-1 and D-dimer in patients with chronic pulmonary heart disease.J Clin Intern Med China 2001;18:343-344.
    24. He CF, Wu JH. Clinical investigation of sodium ferulate treatment in patients with chronic pulmonary heart disease. Sichuan Med J 2003;24:46-47.
    25. Ji J, Mei YH, Cai G, Lu WZ,Wang YP. Sodium ferulate in treatment of patients with heart failure due to pulmonary heart disease. J Pract Med Pharm China 2000; 13:1-2
    26. Zhou CH, Qing Y. Clinical investigation of sodium ferulate injection in patients with pulmonary heart disease heart failure. Chin J Prim Med Pharmacy 2002;9:24-25
    27. Suzuki A, Yamamoto M, Jokura H, Fujii A, Tokimitsu I, Hase T, Saito I. Ferulic acid restores endothelium-dependent vasodilation in aortas of spontaneously hypertensive rats. Am J Hypertens 2007,20:508-513.
    28. Homma N, Morio Y, Takahashi H, Yamamoto A, Suzuki T, Sato K, et al. Genistein, a phytoestrogen, attenuates monocrotaline-induced pulmonary hypertension. Respiration 2006,73:105-112.
    29. Hou YZ, Yang J, Zhao GR, Yuan YJ. Ferulic acid inhibits vascular smooth muscle cell proliferation induced by angiotensin II. Eur J Pharmacol 2004,499:85-90.
    30. Hou Y, Yang J, Zhao G, Yuan Y. Ferulic acid inhibits endothelial cell proliferation through NO down-regulating ERK1/2 pathway. J Cell Biochem 2004,93:1203-1209.
    31. Archer SL, Djaballah K, Humbert M, Weir KE, Fartoukh M, Dall SJ, et al. Nitric oxide deficiency in fenfluramine- and dexfenfluramine-induced pulmonary hypertension. Am J Respir Crit Care Med 1998,158:1061-1067.
    32. Gianetti J, Bevilacqua S, De CR. Inhaled nitric oxide: more than a selective pulmonary vasodilator. Eur J Clin Invest 2002,32:628-635.
    33. Giaid A, Saleh D. Reduced expression of endothelial nitric oxide synthase in the lungs of patients with pulmonary hypertension. N Engl J Med 1995,333:214-221.
    34. Demoncheaux EA, Higenbottam TW, Kiely DG, Wong JM, Wharton S, Varcoe R, et al. Decreased whole body endogenous nitric oxide production in patients with primary pulmonary hypertension. J Vasc Res 2005,42:133-136.
    35.Giaid A,Saleh D.Reduced expression of endothelial nitric oxide synthase in the lungs of patients with pulmonary hypertension.N Engl J Med 1995,333:214-221.
    36.Yetik-Anacak G,Catravas JD.Nitric oxide and the endothelium:history and impact on cardiovascular disease.Vascul Pharmacol 2006,45:268-276.
    37.Wilcox JN,Subramanian RR,Sundell CL,Tracey WR,Pollock JS,Harrison DG,Marsden PA.Expression of multiple isoforms of nitric oxide synthase in normal and atherosclerotic vessels.Arterioscler Thromb Vase Biol 1997,17:2479-2488.
    38.Chan Y,Fish JE,D AC,Lin S,Robb GB,Teichert AM,et al.The cell-specific expression of endothelial nitric-oxide synthase:a role for DNA methylation.J Biol Chem 2004,279:35087-35100.
    39.Pepke-Zaba J,Morrell NW.The endothelin system and its role in pulmonary arterial hypertension(PAH).Thorax 2005,60:443-444.
    40.Chen YF,Oparil S.Endothelin and pulmonary hypertension.J Cardiovasc Pharmacol 2000,35:49-53.
    41.Giaid A,Yanagisawa M,Langleben D,Michel RP,Levy R,Shennib H,et al.Expression of endothelin-1 in the lungs of patients with pulmonary hypertension.N Engl J Med 1993,328:1732-1739.
    42.王峰,王京援,李菲,等.咖啡酸、阿魏酸钠和CA-1201拮抗ET-1的生物效应.中国病理生理杂志.1999:15:688-691
    43.Wilt T J,Niewoehner D,MacDonald R,Kane RL.Management of stable chronic obstructive pulmonary disease:a systematic review for a clinical practice guideline.Ann Intern Med 2007,147:639-653.
    44.Badesch DB,Tapson VF,McGoon MD,Brundage BH,Rubin LJ,Wigley FM,et al.Continuous intravenous epoprostenol for pulmonary hypertension due to the scleroderma spectrum of disease.A randomized,controlled trial.Ann Intern Med 2000,132:425-434.
    45.Hoeper MM,Schwarze M,Ehlerding S,Adler-Schuermeyer A,Spiekerkoetter E,Niedermeyer J,et al.Long-term treatment of primary pulmonary hypertension with aerosolized iloprost,a prostacyclin analogue.N Engl J Med 2000,342:1866-1870.
    46.Sitbon O,Badesch DB,Channick RN,Frost A,Robbins IM,Simormeau G,et al. Effects of the dual endothelin receptor antagonist bosentan in patients with pulmonary arterial hypertension:a 1-year follow-up study.Chest 2003,124:247-254.
    47.Kim NH,Channick RN,Rubin LJ.Successful withdrawal of long-term epoprostenol therapy for pulmonary arterial hypertension.Chest 2003,124:1612-1615.
    48.Ghofrani HA,Rose F,Schermuly RT,Olschewski H,Wiedemann R,Kreckel A,et al.Oral sildenafil as long-term adjunct therapy to inhaled iloprost in severe pulmonary arterial hypertension.J Am Coll Cardiol 2003,42:158-164.
    1. DRESDALE DT, SCHULTZ M, MICHTOM RJ. Primary pulmonary hypertension. I. Clinical and hemodynamic study. Am J Med 1951,11:686-705.
    2. Fishman AP. Clinical classification of pulmonary hypertension. Clin Chest Med 2001,22:385-391.
    3. Galie N, Torbicki A, Barst R, Dartevelle P, Haworth S, Higenbottam T, et al. Guidelines on diagnosis and treatment of pulmonary arterial hypertension. The Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology. Eur Heart J 2004,25:2243-2278.
    4. D AG, Barst RJ, Ayres SM, Bergofsky EH, Bmndage BH, Detre KM, et al. Survival in patients with primary pulmonary hypertension. Results from a national prospective registry. Ann Intern Med 1991,115:343-349.
    5. Fishman AP. Primary pulmonary arterial hypertension: a look back. J Am Coll Cardiol 2004,43:2-4.
    6. Pietra GG, Capron F, Stewart S, Leone O, Humbert M, Robbins IM, et al. Pathologic assessment of vasculopathies in pulmonary hypertension. J Am Coll Cardiol 2004,43:25-32.
    7. Jeffery TK, Morrell NW. Molecular and cellular basis of pulmonary vascular remodeling in pulmonary hypertension. Prog Cardiovasc Dis 2002,45:173-202.
    8. Humbert M, Morrell NW, Archer SL, Stenmark KR, MacLean MR, Lang IM, et al. Cellular and molecular pathobiology of pulmonary arterial hypertension. J Am Coll Cardiol 2004,43:13-24.
    9. Stenmark KR, Gerasimovskaya E, Nemenoff RA, Das M. Hypoxic activation of adventitial fibroblasts: role in vascular remodeling. Chest 2002,122:326-334.
    10. Davie NJ, Crossno JT, Frid MG, Hofmeister SE, Reeves JT, Hyde DM, et al. Hypoxia-induced pulmonary artery adventitial remodeling and neovascularization: contribution of progenitor cells. Am J Physiol Lung Cell Mol Physiol 2004,286:668-678.
    11. Galie N, Torbicki A, Barst R, Dartevelle P, Haworth S, Higenbottam T, et al. Guidelines on diagnosis and treatment of pulmonary arterial hypertension. The Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology. Eur Heart J 2004,25:2243-2278.
    12. Budhiraja R, Tuder RM, Hassoun PM. Endothelial dysfunction in pulmonary hypertension. Circulation 2004,109:159-165.
    13. Haworth SG. Role of the endothelium in pulmonary arterial hypertension. Vascul Pharmacol 2006,45:317-325.
    14. Lee SD, Shroyer KR, Markham NE, Cool CD, Voelkel NF, Tuder RM. Monoclonal endothelial cell proliferation is present in primary but not secondary pulmonary hypertension. J Clin Invest 1998,101:927-934.
    15. Cool CD, Stewart JS, Werahera P, Miller GJ, Williams RL, Voelkel NF, Tuder RM. Three-dimensional reconstruction of pulmonary arteries in plexiform pulmonary hypertension using cell-specific markers. Evidence for a dynamic and heterogeneous process of pulmonary endothelial cell growth. Am J Pathol 1999,155:411-419.
    16. Yeager ME, Halley GR, Golpon HA, Voelkel NF, Tuder RM. Microsatellite instability of endothelial cell growth and apoptosis genes within plexiform lesions in primary pulmonary hypertension. Circ Res 2001,88:2-11.
    17. Cool CD, Rai PR, Yeager ME, Hernandez-Saavedra D, Serls AE, Bull TM, et al. Expression of human herpesvirus 8 in primary pulmonary hypertension. N Engl J Med 2003,349:1113-1122.
    18. Balabanian K, Foussat A, Dorfmuller P, Durand-Gasselin I, Capel F, Bouchet-Delbos L, et al. CX(3)C chemokine fractalkine in pulmonary arterial hypertension. Am J Respir Crit Care Med 2002,165:1419-1425.
    19. Dorfmuller P, Perros F, Balabanian K, Humbert M. Inflammation in pulmonary arterial hypertension. Eur Respir J 2003,22:358-363.
    20. Mouthon L, Guillevin L, Humbert M. Pulmonary arterial hypertension: an autoimmune disease? Eur Respir J 2005,26:986-988.
    21. Herve P, Humbert M, Sitbon O, Parent F, Nunes H, Legal C, et al Pathobiology of pulmonary hypertension. The role of platelets and thrombosis. Clin Chest Med 2001,22:451-458.
    22. Tuder RM, Cool CD, Geraci MW, Wang J, Abman SH, Wright L, et al. Prostacyclin synthase expression is decreased in lungs from patients with severe pulmonary hypertension. Am J Respir Crit Care Med 1999,159:1925-1932.
    23. Christman BW, McPherson CD, Newman JH, King GA, Bernard GR, Groves BM, Loyd JE. An imbalance between the excretion of thromboxane and prostacyclin metabolites in pulmonary hypertension. N Engl J Med 1992,327:70-75.
    24. Giaid A, Saleh D. Reduced expression of endothelial nitric oxide synthase in the lungs of patients with pulmonary hypertension. N Engl J Med 1995,333:214-221.
    25. Michelakis ED, Tymchak W, Noga M, Webster L, Wu XC, Lien D, et al. Long-term treatment with oral sildenafil is safe and improves functional capacity and hemodynamics in patients with pulmonary arterial hypertension. Circulation 2003,108:2066-2069.
    26. Petkov V, Mosgoeller W, Ziesche R, Raderer M, Stiebellehner L, Vonbank K, et al. Vasoactive intestinal peptide as a new drug for treatment of primary pulmonary hypertension. J Clin Invest 2003,111:1339-1346.
    27. Giaid A, Yanagisawa M, Langleben D, Michel RP, Levy R, Shennib H, et al. Expression of endothelin-1 in the lungs of patients with pulmonary hypertension. N Engl J Med 1993,328:1732-1739.
    28. Geraci MW, Moore M, Gesell T, Yeager ME, Alger L, Golpon H, et al. Gene expression patterns in the lungs of patients with primary pulmonary hypertension: a gene microarray analysis. Circ Res 2001,88:555-562.
    29.Archer S,Rich S.Primary pulmonary hypertension:a vascular biology and translational research "Work in progress".Circulation 2000,102:2781-2791.
    30.Michelakis ED,McMurtry MS,Wu XC,Dyck JR,Moudgil R,Hopkins TA,et al.Dichloroacetate,a metabolic modulator,prevents and reverses chronic hypoxic pulmonary hypertension in rats:role of increased expression and activity of voltage-gated potassium channels.Circulation 2002,105:244-250.
    31.Yuan XJ,Wang J,Juhaszova M,Gaine SP,Rubin LJ.Attenuated K+channel gene transcription in primary pulmonary hypertension.Lancet 1998,351:726-727.
    32.Weir EK,Reeve HL,Huang JM,Michelakis E,Nelson DP,Hampl V,Archer SL.Anorexic agents aminorex,fenfluramine,and dexfenfluramine inhibit potassium current in rat pulmonary vascular smooth muscle and cause pulmonary vasoconstriction.Circulation 1996,94:2216-2220.
    33.Herve P,Launay JM,Scrobohaci ML,Brenot F,Simonneau G,Petitpretz P,et al.Increased plasma serotonin in primary pulmonary hypertension.Am J Med 1995,99:249-254.
    34.MacLean MR,Herve P,Eddahibi S,Adnot S.5-hydroxytryptamine and the pulmonary circulation:receptors,transporters and relevance to pulmonary arterial hypertension.Br J Pharmacol 2000,131:161-168.
    35.MacLean MR,Deuchar GA,Hicks MN,Morecroft I,Shen S,Sheward J,et al.Overexpression of the 5-hydroxytryptamine transporter gene:effect on pulmonary hemodynamics and hypoxia-induced pulmonary hypertension.Circulation 2004,109:2150-2155.
    36.Marcos E,Adnot S,Pham MH,Nosjean A,Raffestin B,Hamon M,Eddahibi S.Serotonin transporter inhibitors protect against hypoxic pulmonary hypertension.Am J Respir Crit Care Med 2003,168:487-493.
    37.Eddahibi S,Humbert M,Fadel E,Raffestin B,Darmon M,Capron F,et al.Serotonin transporter overexpression is responsible for pulmonary artery smooth muscle hyperplasia in primary pulmonary hypertension.J Clin Invest 2001,108:1141-1150.
    38.Eddahibi S,Chaouat A,Morrell N,Fadel E,Fuhrman C,Bugnet AS,et al.Polymorphism of the serotonin transporter gene and pulmonary hypertension in chronic obstructive pulmonary disease.Circulation 2003,108:1839-1844.
    39.Morecroft I,Heeley RP,Prentice HM,Kirk A,MacLean MR.5-hydroxytryptamine receptors mediating contraction in human small muscular pulmonary arteries:importance of the 5-HT1B receptor.Br J Pharmacol 1999,128:730-734.
    40.Keegan A,Morecroft I,Smillie D,Hicks MN,MacLean MR.Contribution of the 5-HT(1B) receptor to hypoxia-induced pulmonary hypertension:converging evidence using 5-HT(1B)-receptor knockout mice and the 5-HT(1B/1D)-receptor antagonist GR127935.Circ Res 2001,89:1231-1239.
    41.Launay JM,Herve P,Peoc K,Tournois C,Callebert J,Nebigil CG,et al.Function of the serotonin 5-hydroxytryptamine 2B receptor in pulmonary hypertension.Nat Med 2002,8:1129-1135.
    42.Shi Y,Massague J.Mechanisms of TGF-beta signaling from cell membrane to the nucleus.Cell 2003,113:685-700.
    43.Massague J,Chen YG.Controlling TGF-beta signaling.Genes Dev 2000,14:627-644.
    44.Lane KB,Machado RD,Pauciulo MW,Thomson JR,Phillips JA,Loyd JE,et al.Heterozygous germline mutations in BMPR2,encoding a TGF-beta receptor,cause familial primary pulmonary hypertension.The International PPH Consortium.Nat Genet 2000,26:81-84.
    45.Deng Z,Morse JH,Slager SL,Cuervo N,Moore KJ,Venetos G,et al.Familial primary pulmonary hypertension(gene PPH1) is caused by mutations in the bone morphogenetic protein receptor-Ⅱ gene.Am J Hum Genet 2000,67:737-744.
    46.Thomson JR,Machado RD,Pauciulo MW,Morgan NV,Humbert M,Elliott GC,et al.Sporadic primary pulmonary hypertension is associated with germline mutations of the gene encoding BMPR-II, a receptor member of the TGF-beta family. J Med Genet 2000,37:741-745.
    47. Atkinson C, Stewart S, Upton PD, Machado R, Thomson JR, Trembath RC, Morrell NW. Primary pulmonary hypertension is associated with reduced pulmonary vascular expression of type II bone morphogenetic protein receptor. Circulation 2002,105:1672-1678.
    48. Trembath RC, Thomson JR, Machado RD, Morgan NV, Atkinson C, Winship I, et al. Clinical and molecular genetic features of pulmonary hypertension in patients with hereditary hemorrhagic telangiectasia. N Engl J Med 2001,345:325-334.
    49. Chaouat A, Coulet F, Favre C, Simonneau G, Weitzenblum E, Soubrier F, Humbert M. Endoglin germline mutation in a patient with hereditary haemorrhagic telangiectasia and dexfenfluramine associated pulmonary arterial hypertension. Thorax 2004,59:446-448.
    50. Rudarakanchana N, Flanagan JA, Chen H, Upton PD, Machado R, Patel D, et al. Functional analysis of bone morphogenetic protein type II receptor mutations underlying primary pulmonary hypertension. Hum Mol Genet 2002,11:1517-1525.
    51. Beppu H, Kawabata M, Hamamoto T, Chytil A, Minowa O, Noda T, Miyazono K. BMP type II receptor is required for gastrulation and early development of mouse embryos. Dev Biol 2000,221:249-258.
    52. Morrell NW, Yang X, Upton PD, Jourdan KB, Morgan N, Sheares KK, Trembath RC. Altered growth responses of pulmonary artery smooth muscle cells from patients with primary pulmonary hypertension to transforming growth factor-beta(1) and bone morphogenetic proteins. Circulation 2001,104:790-795.
    53. Machado RD, Pauciulo MW, Thomson JR, Lane KB, Morgan NV, Wheeler L, et al. BMPR2 haploinsufficiency as the inherited molecular mechanism for primary pulmonary hypertension. Am J Hum Genet 2001,68:92-102.
    54.Markewitz BA,Farrukh IS,Chen Y,Li Y,Michael JR.Regulation of endothelin-1 synthesis in human pulmonary arterial smooth muscle cells.Effects of transforming growth factor-beta and hypoxia.Cardiovasc Res 2001,49:200-206.
    55.Kucich U,Rosenbloom JC,Herrick DJ,Abrams WR,Hamilton AD,Sebti SM,Rosenbloom J.Signaling events required for transforming growth factor-beta stimulation of connective tissue growth factor expression by cultured human lung fibroblasts.Arch Biochem Biophys 2001,395:103-112.
    56.Du L,Sullivan CC,Chu D,Cho AJ,Kido M,Wolf PL,et al.Signaling molecules in nonfamilial pulmonary hypertension.N Engl J Med 2003,348:500-509.
    57.Botney MD,Bahadori L,Gold LI.Vascular remodeling in primary pulmonary hypertension.Potential role for transforming growth factor-beta.Am J Pathol 1994,144:286-295.
    58.Campbell AI,Zhao Y,Sandhu R,Stewart DJ.Cell-based gene transfer of vascular endothelial growth factor attenuates monocrotaline-induced pulmonary hypertension.Circulation 2001,104:2242-2248.
    59.Tuder RM,Chacon M,Alger L,Wang J,Taraseviciene-Stewart L,Kasahara Y,et al.Expression of angiogenesis-related molecules in plexiform lesions in severe pulmonary hypertension:evidence for a process of disordered angiogenesis.J Patho12001,195:36 7-374.
    60.Wanstall JC,Gambino A,Jeffery TK,Cahill MM,Bellomo D,Hayward NK,Kay GF.Vascular endothelial growth factor-B-deficient mice show impaired development of hypoxic pulmonary hypertension.Cardiovasc Res 2002,55:361-368.
    61.Taraseviciene-Stewart L,Kasahara Y,Alger L,Hirth P,Mc MG,Waltenberger J,et al.Inhibition of the VEGF receptor 2 combined with chronic hypoxia causes cell death-dependent pulmonary endothelial cell proliferation and severe pulmonary hypertension.FASEB J 2001,15:427-438.
    62.Hirose S,Hosoda Y,Furuya S,Otsuki T,Ikeda E.Expression of vascular endothelial growth factor and its receptors correlates closely with formation of the plexiform lesion in human pulmonary hypertension.Pathol Int 2000,50:472-479.
    63.Sullivan CC,Du L,Chu D,Cho AJ,Kido M,Wolf PL,et al.Induction of pulmonary hypertension by an angiopoietin 1/TIE2/serotonin pathway.Proc Natl Acad Sci USA 2003,100:12331-12336.
    64.Zhao YD,Campbell AI,Robb M,Ng D,Stewart DJ.Protective role of angiopoietin-1 in experimental pulmonary hypertension.Circ Res 2003,92:984-991.
    65.Rabinovitch M.Elastase and the pathobiology of unexplained pulmonary hypertension.Chest 1998,114:213-224.
    66.Cowan KN,Jones PL,Rabinovitch M.Elastase and matrix metailoproteinase inhibitors induce regression,and tenascin-C antisense prevents progression,of vascular disease.J Clin Invest 2000,105:21-34.
    67.Mitani Y,Zaidi SH,Dufourcq P,Thompson K,Rabinovitch M.Nitric oxide reduces vascular smooth muscle cell elastase activity through cGMP-mediated suppression of ERK phosphorylation and AML1B nuclear partitioning.FASEB J 2000,14:805-814.
    68.Rich S,Dantzker DR,Ayres SM,Bergofsky EH,Brundage BH,Detre KM,et al.Primary pulmonary hypertension.A national prospective study,Ann Intern Med 1987,107:216-223.
    69.Ahearn GS,Tapson VF,Rebeiz A,Greenfield JC.Electrocardiography to define clinical status in primary pulmonary hypertension and pulmonary arterial hypertension secondary to collagen vascular disease.Chest 2002,122:524-527.
    70.Denton CP,Caries JB,Phillips GD,Wells AU,Black CM,Bois RM.Comparison of Doppler echocardiography and right heart catheterization to assess pulmonary hypertension in systemic sclerosis.Br J Rheumatol 1997,36:239-243.
    71. Fedullo PF, Auger WR, Kerr KM, Rubin LJ. Chronic thromboembolic pulmonary hypertension. N Engl J Med 2001,345:1465-1472.
    72. Resten A, Maitre S, Humbert M, Rabiller A, Sitbon O, Capron F, et al. Pulmonary hypertension: CT of the chest in pulmonary venoocclusive disease. AJR Am J Roentgenol 2004,183:65-70.
    73. Ley S, Kreitner KF, Fink C, Heussel CP, Borst MM, Kauczor HU. Assessment of pulmonary hypertension by CT and MR imaging. Eur Radiol 2004,14:359-368.
    74. Miyamoto S, Nagaya N, Satoh T, Kyotani S, Sakamaki F, Fujita M, et al. Clinical correlates and prognostic significance of six-minute walk test in patients with primary pulmonary hypertension. Comparison with cardiopulmonary exercise testing. Am J Respir Crit Care Med 2000,161:487-492.
    75. Barst RJ, McGoon M, McLaughlin V, Tapson V, Rich S, Rubin L, et al. Beraprost therapy for pulmonary arterial hypertension. J Am Coll Cardiol 2003,41:2119-2125.
    76. Sitbon O, Humbert M, Jais X, Ioos V, Hamid AM, Provencher S, et al. Long-term response to calcium channel blockers in idiopathic pulmonary arterial hypertension. Circulation 2005,111:3105-3 111.
    77. McLaughlin VV, Shillington A, Rich S. Survival in primary pulmonary hypertension: the impact of epoprostenol therapy. Circulation 2002,106:1477-1482.
    78. Sitbon O, Humbert M, Nunes H, Parent F, Garcia G, Herve P, et al. Long-term intravenous epoprostenol infusion in primary pulmonary hypertension: prognostic factors and survival. J Am Coll Cardiol 2002,40:780-788.
    79. Voelkel MA, Wynne KM, Badesch DB, Groves BM, Voelkel NF. Hyperuricemia in severe pulmonary hypertension. Chest 2000,117:19-24.
    80. Mereles D, Ehlken N, Kreuscher S, Ghofrani S, Hoeper MM, Halank M, et al. Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension. Circulation 2006,114:1482-1489.
    81. Nelson DM, Main E, Crafford W, Ahumada GG. Peripartum heart failure due to primary pulmonary hypertension. Obstet Gynecol 1983,62:58-63.
    82. Weiss BM, Zemp L, Seifert B, Hess OM. Outcome of pulmonary vascular disease in pregnancy: a systematic overview from 1978 through 1996. J Am Coll Cardiol 1998,31:1650-1657.
    83. Deanfield J, Thaulow E, Warnes C, Webb G, Kolbel F, Hoffman A, et al Management of grown up congenital heart disease. Eur Heart J 2003,24:1035-1084.
    84. Girgis A, Sanson-Fisher RW. Breaking bad news: consensus guidelines for medical practitioners. J Clin Oncol 1995,13:2449-2456.
    85. Friedman R, Mears JG, Barst RJ. Continuous infusion of prostacyclin normalizes plasma markers of endothelial cell injury and platelet aggregation in primary pulmonary hypertension. Circulation 1997,96:2782-2784.
    86. Moser KM, Fedullo PF, Finkbeiner WE, Golden J. Do patients with primary pulmonary hypertension develop extensive central thrombi? Circulation 1995, 91:741 -745.
    87. Rich S, Kaufmann E, Levy PS. The effect of high doses of calcium-channel blockers on survival in primary pulmonary hypertension. N Engl J Med 1992,327:76-81.
    88. Fuster V, Steele PM, Edwards WD, Gersh BJ, McGoon MD, Frye RL. Primary pulmonary hypertension: natural history and the importance of thrombosis. Circulation 1984,70:580-587.
    89. Frank H, Mlczoch J, Huber K, Schuster E, Gurtner HP, Kneussl M. The effect of anticoagulant therapy in primary and anorectic drug-induced pulmonary hypertension. Chest 1997,112:714-721.
    90. Badesch DB, Tapson VF, McGoon MD, Brundage BH, Rubin LJ, Wigley FM, et al. Continuous intravenous epoprostenol for pulmonary hypertension due to the scleroderma spectrum of disease.A randomized,controlled trial.Ann Intern Med 2000,132:425-434.
    91.Sandoval J,Aguirre JS,Pulido T,Martinez-Guerra ML,Santos E,Alvarado P,et al.Nocturnal oxygen therapy in patients with the Eisenmenger syndrome.Am J Respir Crit Care Med 2001,164:1682-1687.
    92.Rich S,Seidlitz M,Dodin E,Osimani D,Judd D,Genthner D,et al.The short-term effects of digoxin in patients with right ventricular dysfunction from pulmonary hypertension.Chest 1998,114:787-792.
    93.Naeije R,Vachiery JL.Medical therapy of pulmonary hypertension.Conventional therapies.Clin Chest Med 2001,22:517-527.
    94.Jones DA,Benjamin CW,Linseman DA.Activation of thromboxane and prostacyclin receptors elicits opposing effects on vascular smooth muscle cell growth and mitogen-activated protein kinase signaling cascades.Mol Pharmacol 1995,48:890-896.
    95.Galie N,Manes A,Branzi A.Prostanoids for pulmonary arterial hypertension.Am J Respir Med 2003,2:123-137.
    96.Rosenzweig EB,Kerstein D,Barst RJ.Long-term prostacyclin for pulmonary hypertension with associated congenital heart defects.Circulation 1999,99:1858-1865.
    97.Simonneau G,Barst RJ,Galie N,Naeije R,Rich S,Bourge RC,et al.Continuous subcutaneous infusion of treprostinil,a prostacyclin analogue,in patients with pulmonary arterial hypertension:a double-blind,randomized,placebo-controlled trial.Am J Respir Crit Care Med 2002,165:800-804.
    98.McLaughlin VV,Gaine SP,Barst R J,Oudiz RJ,Bourge RC,Frost A,et al.Efficacy and safety of treprostinih an epoprostenol analog for primary pulmonary hypertension.J Cardiovasc Pharmaco12003,41:293-299.
    99.Vachiery JL,Hill N,Zwicke D,Barst R,Blackburn S,Naeije R.Transitioning from i.v.epoprostenol to subcutaneous treprostinil in pulmonary arterial hypertension.Chest 2002,121:1561-1565.
    100. Galie N, Humbert M, Vachiery JL, Vizza CD, Kneussl M, Manes A, et al. Effects of beraprost sodium, an oral prostacyclin analogue, in patients with pulmonary arterial hypertension: a randomized, double-blind, placebo-controlled trial. J Am Coll Cardiol 2002,39:1496-1502.
    101. Olschewski H, Simonneau G, Galie N, Higenbottam T, Naeije R, Rubin LJ, et al. Inhaled iloprost for severe pulmonary hypertension. N Engl J Med 2002,347:322-329.
    102. Hoeper MM, Schwarze M, Ehlerding S, Adler-Schuermeyer A, Spiekerkoetter E, Niedermeyer J, et al. Long-term treatment of primary pulmonary hypertension with aerosolized iloprost, a prostacyclin analogue. N Engl J Med 2000,342:1866-1870.
    103. Giaid A, Yanagisawa M, Langleben D, Michel RP, Levy R, Shennib H, et al. Expression of endothelin-l in the lungs of patients with pulmonary hypertension. N Engl J Med 1993,328:1732-1739.
    104. Clozel M, Breu V, Burri K, Cassal JM, Fischli W, Gray GA, et al. Pathophysiological role of endothelin revealed by the first orally active endothelin receptor antagonist. Nature 1993,365:759-761.
    105. Rubin LJ, Badesch DB, Barst RJ, Galie N, Black CM, Keogh A, et al. Bosentan therapy for pulmonary arterial hypertension. N Engl J Med 2002,346:896-903.
    106. Sitbon O, Badesch DB, Channick RN, Frost A, Robbins IM, Simonneau G, et al. Effects of the dual endothelin receptor antagonist bosentan in patients with pulmonary arterial hypertension: a 1-year follow-up study. Chest 2003,124:247-254.
    107. Kim NH, Channick RN, Rubin LJ. Successful withdrawal of long-term epoprostenol therapy for pulmonary arterial hypertension. Chest 2003,124:1612-1615.
    108. Barst RJ, Langleben D, Badesch D, Frost A, Lawrence EC, Shapiro S, et al. Treatment of pulmonary arterial hypertension with the selective endothelin-A receptor antagonist sitaxsentan. J Am Coll Cardiol 2006,47:2049-2056.
    109.Barst RJ.A review of pulmonary arterial hypertension:role of ambrisentan.Vasc Health Risk Manag 2007,3:11-22.
    110.Corbin JD,Francis SH.Cyclic GMP phosphodiesterase-5:target of sildenafil.J Biol Chem 1999,274:13729-13732.
    111.Tantini B,Manes A,Fiumana E,Pignatti C,Guarnieri C,Zannoli R,et al.Antiproliferative effect of sildenafil on human pulmonary artery smooth muscle cells.Basic Res Cardio12005,100:131-138.
    112.Galie N,Ghofrani HA,Torbicki A,Barst RJ,Rubin LJ,Badesch D,et al.Sildenafil citrate therapy for pulmonary arterial hypertension.N Engl J Med 2005,353:2148-2157.
    113.Ghofrani HA,Rose F,Schermuly RT,Olschewski H,Wiedemann R,Kreckel A,et al.Oral sildenafil as long-term adjunct therapy to inhaled iloprost in severe pulmonary arterial hypertension.J Am Coll Cardiol 2003,42:158-164.
    114.Humbert M,Barst RJ,Robbins IM,Channick RN,Galie N,Boonstra A,et al.Combination of bosentan with epoprostenol in pulmonary arterial hypertension:BREATHE-2.Eur Respir J 2004,24:353-359.
    115.Hoeper MM,Leuchte H,Halank M,Wilkens H,Meyer FJ,Seyfarth HJ,et al.Combining inhaled iloprost with bosentan in patients with idiopathic pulmonary arterial hypertension.Eur Respir J 2006,28:691-694.
    116.Klepetko W,Mayer E,Sandoval J,Trulock EP,Vachiery JL,Dartevelle P,et al.lnterventional and surgical modalities of treatment for pulmonary arterial hypertension.J Am Coll Cardiol 2004,43:73-80.
    117.Hertz MI,Mohacsi PJ,Taylor DO,Trulock EP,Boucek MM,Deng MC,et al.The registry of the International Society for Heart and Lung Transplantation:introduction to the Twentieth Annual Reports--2003.J Heart Lung Transplant 2003,22:610-615.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700