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Related Concept Videos

Pulmonary Hypertension: Classification and Pathogenesis01:30

Pulmonary Hypertension: Classification and Pathogenesis

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Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
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Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists01:23

Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists

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Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
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Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors01:28

Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors

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Phosphodiesterase 5 (PDE5) inhibitors are potent enzymes that function to hydrolyze cyclic nucleotides to their corresponding 5' monophosphates. Their unique biochemical properties have been applied in treating Pulmonary Arterial Hypertension (PAH).
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
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Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists01:18

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Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
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Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers01:26

Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers

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Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
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Chronic Obstructive Pulmonary Disease-II: Pathophysiology01:20

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Chronic Obstructive Pulmonary Disease (COPD) pathophysiology is intricate and multifaceted, involving a complex interplay of physiological processes. Understanding these mechanisms is crucial for effectively managing and treating COPD. Here is an in-depth look at the critical elements in the pathophysiology of COPD:
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Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets
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Purinergic Dysfunction in Pulmonary Arterial Hypertension.

Zongye Cai1, Ly Tu2,3, Christophe Guignabert2,3

  • 1Division of Experimental Cardiology Department of Cardiology Erasmus MCUniversity Medical Center Rotterdam Rotterdam the Netherlands.

Journal of the American Heart Association
|September 2, 2020
PubMed
Summary

Alterations in purinergic signaling contribute to pulmonary arterial hypertension (PAH). Targeting specific receptors like adenosine A2A and A2B may offer new therapeutic strategies for this severe heart and lung disease.

Keywords:
ATPadenosineextracellular nucleotidespulmonary arterial hypertensionpurinergic receptor

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Area of Science:

  • Cardiovascular Research
  • Pulmonary Hypertension Pathophysiology
  • Purinergic Signaling

Background:

  • Pulmonary arterial hypertension (PAH) is a severe condition leading to right heart failure, with current therapies unable to reverse disease progression.
  • Novel therapeutic targets are crucial for managing PAH.
  • Purinergic signaling, involving nucleotides and nucleosides, is implicated in PAH development.

Purpose of the Study:

  • To review current knowledge on how altered nucleot(s)ide-mediated purinergic signaling contributes to PAH pathogenesis.
  • To highlight the dual role of adenosine receptors (A2A R protective, A2B R deleterious) in PAH.
  • To explore the involvement of P2X7R, P2Y1R, and P2Y12R in PAH vascular tone, remodeling, and inflammation.

Main Methods:

  • Review of existing scientific literature on purinergic signaling in pulmonary arterial hypertension.
  • Analysis of studies investigating nucleotide and nucleoside receptor roles in PAH.
  • Examination of ectonucleotidase function in regulating pulmonary vascular remodeling.

Main Results:

  • Adenosine A2A receptor activation shows protective effects by reducing pulmonary vascular resistance and remodeling.
  • Adenosine A2B receptor activation, P2X7R, P2Y1R, and P2Y12R activation are implicated in promoting PAH.
  • Erythrocyte dysfunction and impaired ATP release in PAH suggest a role in purinergic signaling alterations.

Conclusions:

  • Altered purinergic signaling is a key mechanism in PAH development.
  • Specific purinergic receptors represent potential therapeutic targets for PAH.
  • Further research into erythrocyte function and purinergic pathways is warranted for PAH treatment strategies.