Current approaches in pulmonary arterial hypertension treatment

Abstract

Objective: Pulmonary arterial hypertension (PAH) is a cronic disease with high morbidity and mortality. Although the applied treatment strategies provide an improvement in the quality of life of the patients, PAH continues to be a life-limiting disease for most patients, without the possibility of treatment. The most important problems encountered in the current therapies for PAH are patient incompliance and off-target side effects. In this review, the potential of various new molecular pathways such as rhoA/rho kinase, tyrosine kinase, endothelial progenitor cells, vasoactive intestinal peptide and miRNA are discussed in the treatment of PAH. In addition, various methods for the use of targeted drug delivery systems have been evaluated to improve the efficacy of approved and investigational drugs. Result and Discussion: PAH is a cronic disease characterized by increased pulmonary vascular resistance and progressive pulmonary vascular functional and structural changes that eventually result in right heart failure and death. Increasing knowledge about the cellular and molecular mechanisms responsible for PAH pathophysiology has led to the emergence of new therapeutic approaches for PAH treatment. These approaches include the use of various new molecular pathways such as rhoA/rho kinase, tyrosine kinase, endothelial progenitor cells, vasoactive intestinal peptide, and miRNA. Furthermore, the use of drug delivery systems in the treatment of PAH has been promising in terms of achieving the optimum effect and reducing the potential for side effects by ensuring that the active substances are targeted locally to the effect area.