Pharmacological Agents and Potential New Therapies in Pulmonary Arterial Hypertension.
Renata Trabach SantosMaria Eduarda de Sá Freire OnofreDayene de Assis Fernandes CaldeiraAdriane Bello KleinPatricia Rieken Macêdo RoccoFernanda Ferreira CruzPedro Leme SilvaPublished in: Current vascular pharmacology (2023)
Pulmonary arterial hypertension (PAH) is a progressive disease characterized by an imbalance between vasoactive mediators, which causes vascular remodeling, increased pulmonary vascular resistance, and right ventricular overload, ultimately leading to heart failure and death. A metabolic theory has been suggested to explain the pathophysiology of PAH whereby abnormalities in mitochondrial biogenesis can trigger a hyperproliferative and apoptosis-resistant phenotype in cardiopulmonary and malignant cells, leading to mitochondrial dysfunction, which in turn causes the Warburg effect. This can culminate in the mitophagy of pulmonary vessels and cardiomyocytes. The present narrative review focuses on the pathophysiology of PAH, the pharmacological agents currently available for its treatment, and promising and challenging areas of therapeutic investigation.
Keyphrases
- pulmonary arterial hypertension
- pulmonary hypertension
- cell cycle arrest
- pulmonary artery
- heart failure
- oxidative stress
- induced apoptosis
- polycyclic aromatic hydrocarbons
- cell death
- endoplasmic reticulum stress
- multiple sclerosis
- atrial fibrillation
- left ventricular
- sensitive detection
- combination therapy
- nlrp inflammasome
- human health
- endothelial cells
- quantum dots