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Although prostaglandin El (PGE ) has been clinically available for
a long 1 time, only in recent years has its effectiveness in
peripheral arterial occlusive disease been confirmed in controlled
studies. Not surprisingly, the favour able results achieved both in
patients with critical limb ischaemia and in those with
intermittent claudication has stimulated research activities into
the clinical pharmacology of this prostaglandin. As a consequence
of these efforts, exciting new findings have revealed that PGE has
anti thrombotic, endothelium-stabilizing and leucocyte-stabi 1
lizing properties as well as effects on lipid metabolism, all of
which, quite apart from its well-known anti-aggregating and
vasodilator effects, may add to the clinical efficacy of the
substance. New data have also been gathered on the metabolism of
PGE most b notably the detection of 13,14-dihydro-PGE a metabolite
which was b recently isolated in humans following the
administration of PGE . Being 1 biologically active, the
pharmacodynamic spectrum of 13,14-dihydro-PGE 1 very closely
resembles that of PGE . This finding may help to explain the 1
efficacy of PGE despite its rapid metabolization when given
intravenously."
Dieses erste deutschsprachige Buch zum Thema der pharmakologischen
und therapeutischen Wirksamkeit von Prostaglandin E1 enthalt
aktuelle zusammengefasste Originalarbeiten. Neben den bekannten
vasodilatierenden und die Thrombozytenfunktion hemmenden
Eigenschaften werden eine Vielzahl weiterer Wirkmechanismen
nachgewiesen, so der positive Einfluss auf die Pathogenese und
Progression der Atherosklerose, die Aktivierung der endogenen
Fibrinolyse, die Hemmung der Neutrophilen-Aktivierung und die
Okonomisierung des zellularen Stoffwechsels. Die Wirksamkeit von
intraarteriell und intravenos appliziertem Prostaglandin E1 bei
schwerer arterieller Verschlusskrankheit wird durch kontrollierte
Studien an Patienten mit Claudicatio, Ruheschmerzen oder Nekrosen
belegt sowie weitere Indikationen diskutiert.
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