1. Pharmacological Options for the Treatment of Pulmonary Arterial Hypertension
- Author
-
Škreblin, Nikolina and Bach-Rojecky, Lidija
- Subjects
plućna arterijska hipertenzija ,endotelinski put ,serotonine pathway in pulmonary arterial hypertension ,analozi prostaciklina ,phosphodiesterase 5 inhibitors ,endothelin receptor antagonists ,guanilat cyclase agonists ,agonisti gvanilat ciklaze ,put prostaciklina ,antagonisti receptora endotelina ,BIOMEDICINE AND HEALTHCARE. Pharmacy. Pharmacy ,pulmonary arterial hypertension ,endothelin pathway ,prostacyclin pathway ,BIOMEDICINA I ZDRAVSTVO. Farmacija. Farmacija ,put dušikovog oksida ,nitric oxide pathway ,prostacyclin analogs ,inhibitori fosfodiesteraze 5 - Abstract
Plućna arterijska hipertenzija je progresivna bolest pluća s vrlo velikom smrtnošću koja je posljedica zatajenja srca. Budući da se javlja rijetko u populaciji, spada u skupinu rijetkih bolesti (orphan diseases). Zahvaljujući napretku u razumijevanju patobiologije u podlozi ove bolesti razvijeni su brojni lijekovi koji djeluju na jedan od tri ključna signalna puta u glatkim mišićnim stanicama krvnih žila pluća – prostaciklinski, endotelinski i put dušik oksida. Tako su glavne skupine lijekova koji se koriste u terapiji antagonisti endotelinskih receptora, inhibitori fosfodiesteraze 5, stimulator topljive gvanilat ciklaze, sintetski analozi prostaciklina i neprostaciklinski agonisti IP receptora. Svi ovi lijekovi smanjuju endotelnu disfunkciju i dovode do vazodilatacije, ali pritom slabo djeluju na vaskularno remodeliranje. Zbog toga su prvenstveno simptomatska terapija koja blago usporava napredovanje bolesti, što je poticaj daljnim istraživanjima novih terapijskih opcija kako bi usporili ili zaustavili progresiju bolesti djelujući na više patofizioloških putova te u konačnici omogućili oboljelima učinkovitiju i sigurniju terapiju te veću kvalitetu života. Pulmonary arterial hypertension is a progressive lung disease with very high mortality resulting from heart failure. It is a very serious disease that occurs rarely in the population and therefore belongs to the group of orphan diseases. Thanks to the progression in understanding the patobiology underlying this disease many new drugs have been developed. Existing approved drugs act on the major signal pathways in smooth muscle cells. Main groups of drugs used in the therapy of pulmonary arterial hypertension are endothelin receptors antagonists, phosphodiesterase 5 inhibitors, stimulators of soluble guanylate cyclase, synthetic analogs of prostacyclin and agonists of IP receptors. All of these drugs reduce endothelial dysfunction and lead to vasodilation, but have little effect on stopping vascular remodeling. Because drugs which have been approved do not cure the disease but only reduce the symptoms further researches continue in order to find new therapeutic options.
- Published
- 2019