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资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心机构，不一定为研究者机构。GCRC资源利用：呼出的一氧化氮收集和前臂体积描记术摘要：在过去的十年中，医学治疗彻底改变了IPAH的治疗，并延迟或消除了许多患者对肺移植的需求。然而，肺移植仍然在医疗失败的患者的护理中发挥作用。不幸的是，这导致了一组病情严重和极高风险的患者接受移植。因此，在这些患者的治疗中，时机和患者选择已经成为一个非常困难的领域。治疗失败的临床标志物，如血流动力学监测，通常是非常晚的体征，并且治疗失败很难定义。需要对肺动脉高压患者进行无创性检测，以评估对治疗的反应，但目前尚不可用。我们和其他人已经表明，肺动脉高压患者呼出的一氧化氮水平低于健康对照组，支气管肺泡灌洗液中的一氧化氮反应产物与肺动脉高压的程度呈负相关。在开始血管扩张治疗IPAH的患者中，可以看到他们呼出的一氧化氮水平增加。我们还发现，没有一种随时间变化的指标可以预测IPAH患者的死亡率。我们假设IPAH是一种一氧化氮缺乏状态，通过各种方法监测一氧化氮可用于监测IPAH随时间的变化和对治疗的反应。