CLINICAL AND BIOLOGICAL PREDICTORS OF TREATMENT RESPONSE IN IDIOPATHIC PULMON

特发性肺病治疗反应的临床和生物预测因子

• 批准号: 7377725
• 负责人: Raed A. Dweik
• 金额: $ 0.83万
• 依托单位: CLEVELAND CLINIC LERNER COM-CWRU
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7377725
• 关键词: CLINICAL; BIOLOGICAL; PREDICTORS; TREATMENT; RESPONSE

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. GCRC Resource Utilization: Exhaled Nitric Oxide Collection and Forearm Pleythsmography Abstract: Medical Therapies have revolutionized the treatment of IPAH over the past decade and have delayed or eliminated the need for lung transplantation for many patients. However, lung transplantation continues to have a role in the care of patients for whom medical treatment fails. Unfortunately, this has resulted in a group of patients who are very sick and extremely high-risk presenting for transplantation. Thus, timing and patient selection has become a very difficult area in the treatment of these patients. Clinical markers of treatment failure, such as hemodynamic monitoring, are often very late signs and treatment failure is very difficult to define. Noninvasive testing for patients with pulmonary hypertension to evaluate the response to therapy is needed, but not available currently. We and others have shown the exhaled nitric oxide levels are lower in patients with pulmonary hypertension than in healthy controls and that nitric oxide reaction products in the bronchoalveolar lavage fluid is inversely related to the degree of pulmonary hypertension. In patients that begin vasodilator therapy for IPAH, an increase in their exhaled nitric oxide levels is seen. We have also seen that no measure over time can predict mortality in IPAH patients. We hypothesize that IPAH is a nitric oxide deficiency state and monitoring nitric oxide by various methods may be used to monitor IPAH over time and response to therapy.

该子项目是利用 NIH/NCRR 资助的中心拨款提供的资源的众多研究子项目之一。子项目和研究者 (PI) 可能已从另一个 NIH 来源获得主要资金，因此可以在其他 CRISP 条目中出现。列出的机构是中心的机构，不一定是研究者的机构。 GCRC 资源利用：呼出一氧化氮收集和前臂体积描记术 摘要：在过去的十年中，药物治疗彻底改变了 IPAH 的治疗方法，并延迟或消除了许多患者进行肺移植的需要。然而，肺移植仍然在治疗无效的患者的护理中发挥着作用。不幸的是，这导致了一批病情严重且接受移植风险极高的患者。因此，时机和患者选择成为这些患者治疗中非常困难的领域。治疗失败的临床标志物，例如血流动力学监测，通常是很晚的症状，治疗失败很难定义。需要对肺动脉高压患者进行无创检测来评估对治疗的反应，但目前尚不可行。我们和其他人已经证明，肺动脉高压患者呼出的一氧化氮水平低于健康对照，并且支气管肺泡灌洗液中的一氧化氮反应产物与肺动脉高压程度成反比。在开始接受血管扩张剂治疗 IPAH 的患者中，呼出的一氧化氮水平有所增加。我们还发现，随着时间的推移，没有任何措施可以预测 IPAH 患者的死亡率。我们假设 IPAH 是一氧化氮缺乏状态，通过各种方法监测一氧化氮可用于监测 IPAH 随着时间的推移和对治疗的反应。