Titre du document / Document title

Differential effects of cilostazol and pentoxifylline on vascular endothelial growth factor in patients with intermittent claudication

Auteur(s) / Author(s)

LEE Tsung-Ming ⁽¹⁾ ; SU Sheng-Fang ⁽²⁾ ; TSAI Chang-Her ⁽³⁾ ; LEE Yuan-The ⁽¹⁾ ; WANG Shoei-Shen ⁽³⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Internal Medicine, Cardiology Section, College of Medicine, National Taiwan University Hospital, Taipei 10002, TAIWAN, PROVINCE DE CHINE
⁽²⁾ Department of Clinical Pharmacy, College of Medicine, National Cheng Kung University, Tainan, TAIWAN, PROVINCE DE CHINE
⁽³⁾ Department of Surgery, Cardiology Section, College of Medicine, National Taiwan University Hospital, Taipei 10002, TAIWAN, PROVINCE DE CHINE

Résumé / Abstract

Cilostazol is a new phosphodiesterase inhibitor with anti-platelet and vasodilatory properties. Cilostazol and pentoxifylline are the only two drugs that have been approved for the treatment of patients with intermittent claudication. However, the mechanisms by which exercise tolerance is improved remain unclear. Vascular endothelial growth factor (VEGF) is a potent endothelial mitogen that results in angiogenesis when overexpressed in human subjects. To assess the potential role of VEGF in the improvement in exercise tolerance, we investigated plasma levels of VEGF in 50 patients with intermittent claudication who were allocated randomly to groups receiving cilostazol (n = 17), pentoxifylline (n = 17)or placebo (n = 16). Patients given either cilostazol or pentoxifylline showed a significant improvements in maximal walking distance compared with the placebo group (34 m and 33 m respectively, compared with 5 m; both P < 0.05). Neither cilostazol nor pentoxifylline increased the ankle-brachial index after treatment. Circulating VEGF levels were increased (from 116 ± 29 to 169 ± 45 pg/ml; P = 0.002), and the levels of VEGF were correlated significantly with exercise tolerance in a positive direction (r = 0.88, P = 0.004), in those patients treated with cilostazol that did not have diabetes mellitus. In contrast, VEGF levels remained stable after the administration of pentoxifylline. These findings suggest that VEGF may contribute to the cilostazol-related improvement in exercise tolerance in non-diabetic patients. However, pentoxifylline did not affect VEGF levels, although a similar improvement in maximal walking distance was achieved. Thus the mechanisms involved in the pentoxifylline-treated group were different from those in the cilostazol-treated group, and require further study.

Revue / Journal Title

Clinical science   ISSN 0143-5221   CODEN CSCIAE 

Source / Source

2001, vol. 101, n^o3, pp. 305-311 (37 ref.)

Langue / Language

Anglais

Editeur / Publisher

Portland Press, London, ROYAUME-UNI  (1979) (Revue)

Mots-clés anglais / English Keywords

Claudication ; Intermittent ; Limb ; Cilostazol ; Chemotherapy ; Pentoxifylline ; Vascular endothelium growth factor ; Influence ; Clinical pharmacology ; Human ; Xanthine derivatives ; Cardiovascular disease ; Vascular disease ; Arterial disease ; Occlusive arterial disease ; Vasodilator agent ; Fibrinolytic ; Enzyme inhibitor ; 3',5'-Cyclic-nucleotide phosphodiesterase ; Phosphoric diester hydrolases ; Esterases ; Hydrolases ; Enzyme ;

Mots-clés français / French Keywords

Claudication ; Intermittent ; Membre ; Cilostazol ; Chimiothérapie ; Pentoxifylline ; Facteur croissance endothélium vasculaire ; Influence ; Pharmacologie clinique ; Homme ; Xanthine dérivé ; Appareil circulatoire pathologie ; Vaisseau sanguin pathologie ; Artère pathologie ; Artériopathie oblitérante ; Vasodilatateur ; Fibrinolytique ; Inhibiteur enzyme ; 3',5'-Cyclic-nucleotide phosphodiesterase ; Phosphoric diester hydrolases ; Esterases ; Hydrolases ; Enzyme ;

Mots-clés espagnols / Spanish Keywords

Claudicación ; Intermitente ; Miembro ; Cilostazol ; Quimioterapia ; Pentoxifilina ; Factor crecimiento endotelio vascular ; Influencia ; Farmacología clinica ; Hombre ; Xantina derivado ; Aparato circulatorio patología ; Vaso sanguíneo patología ; Arteria patología ; Arteriopatía oclusiva ; Vasodilatador ; Fibrinolítico ; Inhibidor enzima ; 3',5'-Cyclic-nucleotide phosphodiesterase ; Phosphoric diester hydrolases ; Esterases ; Hydrolases ; Enzima ;

Localisation / Location

INIST-CNRS, Cote INIST : 3765, 35400009613556.0120