2000 Fiscal Year Final Research Report Summary
Iontophoretic application of prostaglandin E1 for the treatment of peripheral arterial occlusive disease
| Project/Area Number |
09671222
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
General surgery
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| Research Institution | Nagoya University |
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Principal Investigator |
MATSUSHITA Masahiro School of Medicine, Nagoya University, Research Associate, 医学部, 助手 (70273240)
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| Co-Investigator(Kenkyū-buntansha) |
NISHIKIMI Naomichi School of Medicine, Nagoya University, Assistant Professor, 医学部, 講師 (40242862)
SAKURAI Tsunehisa School of Medicine, Nagoya University, Associate Professor, 医学部, 助教授 (50144142)
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| Project Period (FY) |
1997 – 2000
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| Keywords | Iontophoresis / Prostaglandin E1 / Critical limb ischemia |
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| Research Abstract |
Prostaglandin E1 (PGE1) administered intra-arterially or intravenously has been used clinically in the treatment of peripheral arterial occlusive disease (PAOD). However, intraarterial infusion of PGE1 into an artery is invasive. Intravenous administration of PGE1 is less efficacious and may cause a steal phenomenon. We used iontophoresis to allow high concentrations of PGE1 to be delivered directly to the ischemic foot. Our in vitro study showed that PGE1 permeated through hairless mouse skin iontophoretically, but not by passive transport. Nineteen patients with Arteriosclerosis Obliterans were given PGE1 (20mg) iontophoretically on the dorsum of the foot. The increase rate in cutaneous blood flow as measured by Laser Doppler Flux (LDF) level was significantly higher in the PGE1 than in the control saline. The percent increase in LDF levels with PGE1 was similar in the patients with intermittent claudication and that in critical leg ischemia patients. The percent increase in LDF level was significantly higher with iontophoresis than with intravenous drip infusion of PGE1. Iontophoretic application of the PGE1 was used for the purpose of the treatment of an ischemic foot ulcer in 9 patients. Of those, 4 patients were treated successfully. The percent increase in LDF level was significantly higher in 4 patients treated successfully than in those with failed treatment. This preliminary study addressed the transdermal delivery of PGE1 and the microcirculatory effect of iontophoretically applied PGE1. Iontophoretically delivered PGE1 was beneficial in patients with ischemic ulcer if this treatment could increase blood flow of the skin close to the ulcer.
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