viprostol and Raynaud-Disease

The beneficial effects of intra-arterial or intravenous infusion of the prostanoid products of anachridonic acid, PGE and prostacyclin (PGI2) are well documented. More recently an analogue of PGE2, (CL 115,347, American Cynamid Co.) has become available. This substance is absorbed transdermally from a patch placed on the skin. In a placebo-controlled trial the vasodilatory effect of single incremental dosage, 500 mcg, 1000 mcg and 1500 mcg, was measured in a temperature-/humidity controlled laboratory in normal subjects and in patients with primary and secondary Raynaud's phenomenon. The optimal dosage proved to be 1000 mcg; the effect may last for 84 hours; higher dosage may be associated with a "steal" phenomenon.

Topics: Administration, Topical; Adult; Dinoprostone; Female; Fingers; Humans; Male; Plethysmography; Prostaglandins E, Synthetic; Raynaud Disease; Regional Blood Flow

Vascular prostacyclin (PGI2) regulates platelet function and blood flow. In systemic sclerosis (SS) there is increased platelet aggregation (PA) but no information is available on the platelet/PGI2 relationship. We evaluated platelet sensitivity to a PGI2 analogue ZK36374 in 17 SS patients and 18 controls. The percentage (%) inhibition of PA was measured at two doses of ZK36374 with saline giving the 100% baseline. In the SS group 2 ng ZK36374 produced a percentage inhibition of 19 + 14 compared to a control value of 60 + 21, and 3 ng a percentage inhibition of 47 + 21 in the SS group and 82 + 20 in the controls. In 11 SS patients treated with either prostaglandin E or nifedipine the sensitivity approached normal. These data suggest that SS platelets are less sensitive to the inhibitory effect of PGI2 on PA. This may contribute to the vascular lesions of SS. Other cells are resistant to the effects of PGI2 and our findings support this picture of cellular resistance.

Topics: Adult; Dinoprostone; Dose-Response Relationship, Drug; Epoprostenol; Humans; Iloprost; Middle Aged; Nifedipine; Platelet Aggregation; Prostaglandins E, Synthetic; Prostaglandins, Synthetic; Raynaud Disease; Scleroderma, Systemic

Topics: Administration, Topical; Child; Child, Preschool; Dinoprostone; Humans; Prostaglandins E, Synthetic; Raynaud Disease

We report five children who presented with Raynaud's disease in whom we could find no clinical, haematological, or immunological evidence of a collagen disorder. Oral phenoxybenzamine proved useful for maintenance treatment in most, with infusions of prostacyclin, nitroprusside, and ketanserin during acute attacks.

Topics: Antihypertensive Agents; Child; Dinoprostone; Epoprostenol; Female; Humans; Ketanserin; Male; Nifedipine; Nitroprusside; Phenoxybenzamine; Piperidines; Prostaglandins E, Synthetic; Raynaud Disease