“Denervation” of autonomous nervous system in idiopathic pulmonary arterial hypertension by low-dose radiation: a case report with an unexpected outcome
Vasointestinal peptide metabolism plays a key physiological role in multimodular levels of vasodilatory, smooth muscle cell proliferative, parenchymal, and inflammatory lung reactions. In animal studies, vasointestinal peptide relaxes isolated pulmonary arterial segments from several mammalian speci...
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Dove Medical Press
2014
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972028/ |
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pubmed-39720282014-04-04 “Denervation” of autonomous nervous system in idiopathic pulmonary arterial hypertension by low-dose radiation: a case report with an unexpected outcome Hohenforst-Schmidt, Wolfgang Zarogoulidis, Paul Oezkan, Filiz Mahnkopf, Christian Grabenbauer, Gerhard Kreczy, Alfons Bartunek, Rudolf Darwiche, Kaid Freitag, Lutz Li, Qiang Huang, Haidong Vogl, Thomas LePilvert, Patrick Tsiouda, Theodora Tsakiridis, Kosmas Zarogoulidis, Konstantinos Brachmann, Johannes Hypothesis Vasointestinal peptide metabolism plays a key physiological role in multimodular levels of vasodilatory, smooth muscle cell proliferative, parenchymal, and inflammatory lung reactions. In animal studies, vasointestinal peptide relaxes isolated pulmonary arterial segments from several mammalian species in vitro and neutralizes the pulmonary vasoconstrictor effect of endothelin. In some animal models, it reduces pulmonary vascular resistance in vivo and in monocrotaline-induced pulmonary hypertension. A 58-year-old woman presented with dyspnea and mild edema of the lower extremities. A bronchoscopy was performed without any suspicious findings suggesting a central tumor or other infiltrative disease. Endobronchial ultrasound revealed enlarged pulmonary arteries containing thrombi, a few enlarged lymph nodes, and enlarged mediastinal tissue anatomy with suspicion for mediastinal infiltration of a malignant process. We estimated that less than 10% of the peripheral vascular bed of the lung was involved in direct consolidated fibrosis as demonstrated in the left upper lobe apex. Further, direct involvement of fibrosis around the main stems of the pulmonary arteries was assumed to be low from positron emission tomography and magnetic resonance imaging scans. Assuming a positive influence of low-dose radiation, it was not expected that this could have reduced pulmonary vascular resistance by over two thirds of the initial result. However; it was noted that this patient had idiopathic pulmonary arterial hypertension mixed with “acute” (mediastinal) fibrosis which could have contributed to the unexpected success of reduction of pulmonary vascular resistance. To the best of our knowledge, this is the first report of successful treatment of idiopathic pulmonary arterial hypertension, probably as a result of low-dose radiation to the pulmonary arterial main stems. The patient continues to have no specific complaints concerning her idiopathic pulmonary arterial hypertension. Dove Medical Press 2014-03-27 /pmc/articles/PMC3972028/ /pubmed/24707181 http://dx.doi.org/10.2147/TCRM.S58705 Text en © 2014 Hohenforst-Schmidt et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Hohenforst-Schmidt, Wolfgang Zarogoulidis, Paul Oezkan, Filiz Mahnkopf, Christian Grabenbauer, Gerhard Kreczy, Alfons Bartunek, Rudolf Darwiche, Kaid Freitag, Lutz Li, Qiang Huang, Haidong Vogl, Thomas LePilvert, Patrick Tsiouda, Theodora Tsakiridis, Kosmas Zarogoulidis, Konstantinos Brachmann, Johannes |
| spellingShingle |
Hohenforst-Schmidt, Wolfgang Zarogoulidis, Paul Oezkan, Filiz Mahnkopf, Christian Grabenbauer, Gerhard Kreczy, Alfons Bartunek, Rudolf Darwiche, Kaid Freitag, Lutz Li, Qiang Huang, Haidong Vogl, Thomas LePilvert, Patrick Tsiouda, Theodora Tsakiridis, Kosmas Zarogoulidis, Konstantinos Brachmann, Johannes “Denervation” of autonomous nervous system in idiopathic pulmonary arterial hypertension by low-dose radiation: a case report with an unexpected outcome |
| author_facet |
Hohenforst-Schmidt, Wolfgang Zarogoulidis, Paul Oezkan, Filiz Mahnkopf, Christian Grabenbauer, Gerhard Kreczy, Alfons Bartunek, Rudolf Darwiche, Kaid Freitag, Lutz Li, Qiang Huang, Haidong Vogl, Thomas LePilvert, Patrick Tsiouda, Theodora Tsakiridis, Kosmas Zarogoulidis, Konstantinos Brachmann, Johannes |
| author_sort |
Hohenforst-Schmidt, Wolfgang |
| title |
“Denervation” of autonomous nervous system in idiopathic pulmonary arterial hypertension by low-dose radiation: a case report with an unexpected outcome |
| title_short |
“Denervation” of autonomous nervous system in idiopathic pulmonary arterial hypertension by low-dose radiation: a case report with an unexpected outcome |
| title_full |
“Denervation” of autonomous nervous system in idiopathic pulmonary arterial hypertension by low-dose radiation: a case report with an unexpected outcome |
| title_fullStr |
“Denervation” of autonomous nervous system in idiopathic pulmonary arterial hypertension by low-dose radiation: a case report with an unexpected outcome |
| title_full_unstemmed |
“Denervation” of autonomous nervous system in idiopathic pulmonary arterial hypertension by low-dose radiation: a case report with an unexpected outcome |
| title_sort |
“denervation” of autonomous nervous system in idiopathic pulmonary arterial hypertension by low-dose radiation: a case report with an unexpected outcome |
| description |
Vasointestinal peptide metabolism plays a key physiological role in multimodular levels of vasodilatory, smooth muscle cell proliferative, parenchymal, and inflammatory lung reactions. In animal studies, vasointestinal peptide relaxes isolated pulmonary arterial segments from several mammalian species in vitro and neutralizes the pulmonary vasoconstrictor effect of endothelin. In some animal models, it reduces pulmonary vascular resistance in vivo and in monocrotaline-induced pulmonary hypertension. A 58-year-old woman presented with dyspnea and mild edema of the lower extremities. A bronchoscopy was performed without any suspicious findings suggesting a central tumor or other infiltrative disease. Endobronchial ultrasound revealed enlarged pulmonary arteries containing thrombi, a few enlarged lymph nodes, and enlarged mediastinal tissue anatomy with suspicion for mediastinal infiltration of a malignant process. We estimated that less than 10% of the peripheral vascular bed of the lung was involved in direct consolidated fibrosis as demonstrated in the left upper lobe apex. Further, direct involvement of fibrosis around the main stems of the pulmonary arteries was assumed to be low from positron emission tomography and magnetic resonance imaging scans. Assuming a positive influence of low-dose radiation, it was not expected that this could have reduced pulmonary vascular resistance by over two thirds of the initial result. However; it was noted that this patient had idiopathic pulmonary arterial hypertension mixed with “acute” (mediastinal) fibrosis which could have contributed to the unexpected success of reduction of pulmonary vascular resistance. To the best of our knowledge, this is the first report of successful treatment of idiopathic pulmonary arterial hypertension, probably as a result of low-dose radiation to the pulmonary arterial main stems. The patient continues to have no specific complaints concerning her idiopathic pulmonary arterial hypertension. |
| publisher |
Dove Medical Press |
| publishDate |
2014 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972028/ |
| _version_ |
1612072995437674496 |