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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: Phosphodiesterase Inhibitors01:28

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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

Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists

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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: Oxygen Therapy for Respiratory Failure01:16

Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure

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Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
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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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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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Left Atrial Stenosis Induced Pulmonary Venous Arterialization and Group 2 Pulmonary Hypertension in Rat
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Sex Differences in Pulmonary Hypertension.

Hannah Morris1, Nina Denver2, Rosemary Gaw2

  • 1Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, Scotland; Institute of Cardiovascular and Medical Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Scotland.

Clinics in Chest Medicine
|February 5, 2021
PubMed
Summary

Pulmonary arterial hypertension (PAH) affects women more but men have worse survival. Research explores sex differences in PAH, focusing on serotonin, obesity, and estrogen impacts on the pulmonary system.

Keywords:
BMPR2EstrogensObesityPulmonary circulationPulmonary hypertensionRight ventricleSerotoninSex

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Area of Science:

  • Cardiovascular Research
  • Pulmonary Medicine
  • Endocrinology

Background:

  • Pulmonary arterial hypertension (PAH) exhibits distinct sex-based prevalence and survival rates.
  • Understanding these sex differences is crucial for developing targeted PAH therapies.

Purpose of the Study:

  • To review clinical and preclinical research on sex differences in pulmonary arterial hypertension (PAH).
  • To investigate the roles of serotonin, obesity, estrogen, and related pathways in PAH pathophysiology.

Main Methods:

  • Literature review of clinical and preclinical studies.
  • Analysis of factors influencing bone morphogenetic protein receptor type II (BMPR-II) signaling.
  • Examination of effects on pulmonary circulation and right ventricle function.

Main Results:

  • Sex influences PAH development and outcomes, with women affected more frequently but men experiencing poorer survival.
  • Serotonin, obesity, and estrogen metabolism significantly impact PAH pathogenesis.
  • BMPR-II signaling pathways are differentially affected by sex-related factors.

Conclusions:

  • Sex is a critical determinant in pulmonary arterial hypertension (PAH).
  • Estrogen metabolism and other factors like serotonin and obesity contribute to sex-based disparities in PAH.
  • Further research into these sex differences can guide personalized treatment strategies for PAH.