Vasaprostan treatment of fibrosing alveolitis in patients with pulmonary hypertension

Aim. To study clinical efficacy of vasaprostan in patients with fibrosing alveolitis (FA) complicated by pulmonary hypertension (PH), its effect on functional activity of platelets and endothelium, intensity of free radical processes. Material and methods. Seven FA patients were examined. They had either idiopathic FA or FA with diffuse diseases of the connective tissues. The following methods were used to assess the effect: standard clinical tests, high resolution computer tomography, Doppler echocardiography, definition of the complex thrombin-antithrombin (TAT) and thrombocytic factor 4 (TF-4). Generation ofoxugen active forms by leukocytes was measured by luminol-dependent chemiluminescence. Morphological verification of the diagnosis was made by the results of open pulmonary biopsies. Results. Vasaprostan reduced pressure in the pulmonary artery from 31,6 ± 2,31 to 19,58 ± 3,90 mm Hg (р < 0,05) and coagulation parameters. TAT decreased after 2 and 8 weeks of treatment from 15,25 ± 4,5 to 5,1 ± 0,33 and 2,4 ± 0,31 pg/ml (p < 0,05). Initially low TF-4 (2,11 ± 0,39pg/ml) elevated to the end of the treatment and reached values close to control (4,37 ± 0,25 pg/ml, p < 0,05). Moreover, vasaprostan enhanced the ability of platelets to inhibit generation of active oxygen forms (from 0,9 ± 0,18 to 1,23 ± 0,16 r.u., p < 0,05) and thus depressed activity of lipid peroxidation. Conclusion. Good effect of vasaprostan on platelet activity, free radical processes validates its use in combined treatment of various FA forms for correction of PH, its complications and as an antifibrogenic agent.