Medical therapy of pulmonary hypertension - The prostacyclins

Prostacyclin is a substance produced by endothelial cells that induces vaso dilation and inhibition of platelet aggregation and of vascular cell migrat ion and proliferation. A dysregulation of the prostacyclin metabolic pathwa ys has been shown in patients with pulmonary arterial hypertension. The cli nical use of prostacyclin has been made possible by the synthesis of stable analogues that possesses different pharmacokinetic properties but share si milar pharmacodynamic effects. The greatest experience has been collected w ith intravenous epoprostenol while other compounds like subcutaneous UT-15, inhaled iloprost and oral beraprost are currently in different stages of c linical development. Although favorable results have been reported for each compound, different benefit-to-side effects profiles characterize the vari ous modalities of the administration.