Promising therapeutic effects of sodium tanshinone IIA sulfonate towards pulmonary arterial hypertension in patients.

BACKGROUND Pulmonary hypertension (PH) is a lethal disease with no cure currently available. Sodium Tanshinone IIA sulfonate (STS) is a water-soluble derivative of tanshinone IIA isolated as the major active component from salvia miltiorrhiza, a kind of Chinese herbal medicine. We investigate the efficacy of STS towards treatment of PH patients. METHODS AND RESULTS Five hospitalized patients were randomly enrolled for this study. These patients were suffering from various types of serious PH without getting sufficient benefits from sildenafil treatment (20 mg tid) for at least three months. The efficacy of STS on PH was evaluated by measuring the pulmonary arterial systolic pressure (PASP), RV size by echocardiography, 6-minute walking distance (6MWD), Borg dyspnea score, and WHO functional class of PH. Patients aged from 17 to 46 (average 33±11) years old, pulmonary arterial systolic pressure (PASP) ranged from 60 to 140 mmHg, RV size ranged from 25 to 39 mm were included in study. At the endpoint of observation for 8 weeks of STS infusion, they obtained reduction of PASP in the range of 14-45 (average 28.6±12.5) mmHg, RV size in the range of 0-10 (average 4.2±1.6). All patients exhibited improved exercise capacity with an increase of 6MWD from 63 to 268 (average 138.4±40.7) meters, significantly reduced Borg dyspnea score from maximum 9 down to 1 or 0, and reduced WHO functional class of PH from III or IV down to II. CONCLUSIONS These results indicate that STS exhibits remarkable beneficiary effects on treating PH patients either alone or in concert with sildenafil.

[1]  N. Zhong,et al.  Sodium tanshinone IIA sulfonate inhibits canonical transient receptor potential expression in pulmonary arterial smooth muscle from pulmonary hypertensive rats. , 2013, American journal of respiratory cell and molecular biology.

[2]  D. Taichman,et al.  Characteristics Of Vasoreactive Patients In The Registry To Evaluate Early And Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) , 2012, ATS 2012.

[3]  Hao Xu,et al.  Tanshinone IIA: A Promising Natural Cardioprotective Agent , 2012, Evidence-based complementary and alternative medicine : eCAM.

[4]  A. Levinson,et al.  Combination therapy for the treatment of pulmonary arterial hypertension , 2011, Therapeutic advances in respiratory disease.

[5]  M. Kramer [Combination treatment in pulmonary arterial hypertension]. , 2011, Harefuah.

[6]  Bo Zhang,et al.  Tanshinone IIA modulates pulmonary vascular response to agonist and hypoxia primarily via inhibiting Ca2+ influx and release in normal and hypoxic pulmonary hypertension rats. , 2010, European journal of pharmacology.

[7]  Christopher S Coffey,et al.  Predicting Survival in Pulmonary Arterial Hypertension: Insights From the Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) , 2010, Circulation.

[8]  Gary Wu,et al.  Role of Combination Therapy in the Treatment of Pulmonary Arterial Hypertension , 2010, Pharmacotherapy.

[9]  S. Davidge,et al.  Sodium tanshinone IIA sulfonate increased intestinal hemodynamics without systemic circulatory changes in healthy newborn piglets. , 2009, American journal of physiology. Heart and circulatory physiology.

[10]  Wei-chuan Yang,et al.  Effects of sodium tanshinone II A sulphonate on hypoxic pulmonary hypertension in rats in vivo and on Kv2.1 expression in pulmonary artery smooth muscle cells in vitro. , 2009, Journal of ethnopharmacology.

[11]  G. Filippatos,et al.  Guidelines for the diagnosis and treatment of pulmonary hypertension , 2009 .

[12]  H. Ghofrani,et al.  Updated evidence-based treatment algorithm in pulmonary arterial hypertension. , 2009, Journal of the American College of Cardiology.

[13]  Miaoling Li,et al.  Activation of high conductance Ca(2+)-activated K(+) channels by sodium tanshinoneII-A sulfonate (DS-201) in porcine coronary artery smooth muscle cells. , 2008, European journal of pharmacology.

[14]  Jun Feng,et al.  Effect of sodium tanshinone II A sulfonate on cardiac myocyte hypertrophy and its underlying mechanism , 2008, Chinese journal of integrative medicine.

[15]  R. Benza,et al.  Treprostinil-based therapy in the treatment of moderate-to-severe pulmonary arterial hypertension: long-term efficacy and combination with bosentan. , 2008, Chest.

[16]  C. Ricachinevsky,et al.  Treatment of pulmonary arterial hypertension. , 2006, Jornal de pediatria.

[17]  Zhong Zuo,et al.  Danshen: An Overview of Its Chemistry, Pharmacology, Pharmacokinetics, and Clinical Use , 2005, Journal of clinical pharmacology.

[18]  Y. P. Wang,et al.  [Effects of sodium tanshinone II-A sulfonate and propranolol on coronary collaterals in acutely infarcted dogs (author's transl)]. , 1981, Zhongguo yao li xue bao = Acta pharmacologica Sinica.

[19]  C. Kähler [Combination therapy for the treatment of pulmonary arterial hypertension]. , 2009, Deutsche medizinische Wochenschrift.

[20]  Qiansheng Liang 梁黔生,et al.  Changes of c-fos and c-jun mRNA expression in angiotensin II-induced cardiomyocyte hypertrophy and effects of sodium tanshinone IIA sulfonate , 2008, Journal of Huazhong University of Science and Technology [Medical Sciences].

[21]  M. Humbert,et al.  Successful treatment of systemic sclerosis digital ulcers and pulmonary arterial hypertension with endothelin receptor antagonist bosentan. , 2003, Rheumatology.