Effects of prostaglandin E1 alpha cyclodestrin treatment on endothelial dysfunction in patients with systemic sclerosis

Objective Systemic sclerosis (SSc) is characterized by an altered nitric oxide ( NO) : endothelin I ratio and by endothelial dysfunction. Aims To verify the effects of prostaglandin E-1 (PGE(1)) alpha-cyclodestrin treatment on endothelial function, quantified as flow-mediated dilation (FMD) of the radial artery. Methods In 16 women with SSc ( age 57 2.7 years, means SE) in whom a diagnosis of SSc had been made several years earlier (7.1 1.2 years), FMD was evaluated by an echotracking technique on the radial artery, using trinitroglycerin vasodilation as a non-endothelial measure of the vessel's ability to increase its diameter maximally. FMD was evaluated after 4 months washout period and after 4 months cyclic infusion of PGE(1) alpha-cyclodestrin. Expired NO was measured at the same time. Results PGE(1) alpha-cyclodestrin cyclic infusions did not modify systolic and diastolic blood pressure, heart rate or trinitroglycerin radial artery vasodilation. On the other hand, it induced a marked and significant increase in FMD of the radial artery, which was also accompanied by an increase in blood flow and expired NO. Conclusions Endothelial dysfunction and reduced FMD associated with SSc are improved by cyclic treatment with PGE(1) alpha-cyclodestrin. This effect occurs together with a concomitant increase in expired NO, suggesting its direct positive influence on endothelial function. It may also partly explain the clinical beneficial effect of the drug in SSc.