American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jun 2015
Elafin Reverses Pulmonary Hypertension via Caveolin-1 Dependent Bone Morphogenetic Protein Signaling.
Pulmonary arterial hypertension is characterized by endothelial dysfunction, impaired bone morphogenetic protein receptor 2 (BMPR2) signaling, and increased elastase activity. Synthetic elastase inhibitors reverse experimental pulmonary hypertension but cause hepatotoxicity in clinical studies. The endogenous elastase inhibitor elafin attenuates hypoxic pulmonary hypertension in mice, but its potential to improve endothelial function and BMPR2 signaling, and to reverse severe experimental pulmonary hypertension or vascular pathology in the human disease was unknown. ⋯ Elafin reverses obliterative changes in pulmonary arteries via elastase inhibition and caveolin-1-dependent amplification of BMPR2 signaling.
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Am. J. Respir. Crit. Care Med. · Jun 2015
Clinical TrialEffect of Ultrafiltration on Sleep Apnea and Sleep Structure in Patients with End Stage Renal Disease.
In end-stage renal disease (ESRD), a condition characterized by fluid overload, both obstructive and central sleep apnea (OSA and CSA) are common. This observation suggests that fluid overload is involved in the pathogenesis of OSA and CSA in this condition. ⋯ These findings indicate that fluid overload contributes to the pathogenesis of OSA and CSA in ESRD, and that fluid removal by UF attenuates sleep apnea without altering uremic status.