Effects of alprostadil on blood rheology and nucleoside metabolism in patients affected with lower limb chronic ischaemia

Article type: Research Article

Authors: Acciavatti, A. | Laghi Pasini, F.^{; ;} | Capecchi, P.L.^; | Messa, G.L. | Lazzerini, P.E.^; | De Giorgi, L. | Acampa, M. | Di Perri, T.

Affiliations: Department of Internal Medicine, University of Siena, Siena, Italy | Section of Clinical Immunology, University of Siena, Siena, Italy

Note: [] Corresponding author: Franco Laghi Pasini M.D., Istituto di Semeiotica Medica, Università di Siena, U.O. Immunologia Clinica, Policlinico “Le Scotte”, 53100 Siena, Italy. Tel.: +39 0577 585743/595741; Fax: +39 0577 44114; E‐mail: [email protected].

Abstract: The acute (0.57 μg/kg i.v. in 2 hours) and long‐term (0.57 μg/kg i.v. in 2 hours for 5 days over 4 weeks) effects of the PGE1 analogue alprostadil were studied in patients affected with intermittent claudication. Whole Blood Viscosity (WBV), Whole Blood Filterability (WBF), haematocrit (Htc) and fibrinogen plasma concentration, were studied together with P50, 2,3‐diphosphoglycerate, and adenosine plasma levels. Moreover, in the long‐term study, pain‐free (PFWD) and maximal walking distance (MWD) were measured. Single alprostadil infusion induced an improvement in WBV, WBF, and oxygen transport, and an increase in adenosine plasma levels. Long‐term alprostadil administration produced a decrease in WBV only, without significant changes in WBF, Htc, fibrinogen, P50, 2,3‐diphosphoglycerate, also inducing a significant prolongation of PFWD and MWD. The possibility is suggested that pulse rises in adenosine plasma levels play a role in the effects of chronic alprostadil administration, maybe in a way similar to that observed in the phenomenon of ischaemic preconditioning.

Keywords: Alprostadil, adenosine, haemorheology, oxygen transport, ischaemia

Journal: Clinical Hemorheology and Microcirculation, vol. 24, no. 1, pp. 49-57, 2001