Year: 2009
Type: editorial
Abstract: P ulmonary hypertension (PHTN) remains a disease with high morbidity and mortality and no known cure.The World Health Organization has categorized PHTN into 5 clinical classifications, as follows: (1) pulmonary artery hypertension; (2) PHTN with left heart disease; (3) PHTN with respiratory disease; (4) PHTN caused by chronic thrombotic/embolic disease; and (5) miscellaneous PHTN. 1 Despite the broad and varied nature of these clinical conditions, PHTN presents with similar clinical pathological changes in the lung, including altered vasoreactivity, endothelial dysfunction, vascular intimal and medial remodeling, activation of inflammatory processes, and platelet activation.If untreated, these changes lead to right heart stress, failure, and death. 1 At the cellular level, enhanced vasoconstriction, endothelial dysfunction, and endothelial cell and vascular smooth muscle cell (VSMC) proliferation are key components of disease progression.This underlying pathology is associated with a plethora of molecular changes, eg, increased inflammatory cytokine expression and increased levels of oxidative stress, altered NO bioavailability, and increased growth factor expression.These molecular changes alter the balance of kinase cascades, cAMP, cGMP, and that ultimately modulate K ϩ and Ca 2ϩ channel function and expression, cytoskeletal organization, and cell cycle progression.Current treatment targets for PHTN include Ca 2ϩ channel blockade, selective endothelin A receptor and dual endothelin receptor antagonism, prostanoid replacement, and phosphodiesterase inhibition. 2 These treatments may be applied singularly or in combination to achieve therapeutic goals.Moreover, these therapies have had limited success and are often associated with unwanted adverse effects, including systemic hypotension.The rapid rate of drug discovery for this condition is somewhat reassuring, but finding a single drug therapy that targets the numerous pathological changes in PHTN, free of adverse effects, is less plausible.Over the past 2 decades, increasing attention has been given to red wine polyphenol, resveratrol (3,5,4Јtrihydroxystilbene), a dietary phytoalexin compound.This is attributed in part to its cardioprotective, vasoactive, and anticancer properties.This compound is capable of acting as
Source: Hypertension
Institution: Nationwide Children's Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2158257663