Journalartikel

Treatment with low-dose tacrolimus inhibits bleeding complications in a patient with hereditary hemorrhagic telangiectasia and pulmonary arterial hypertension


AutorenlisteSommer, N.; Droege, F.; Gamen, K. E.; Geisthoff, U.; Gall, H.; Tello, K.; Richter, M. J.; Deubner, L. M.; Schmiedel, R.; Hecker, M.; Spiekerkoetter, E.; Wirsching, K.; Seeger, W.; Ghofrani, H. A.; Pullamsetti, S.

Jahr der Veröffentlichung2018

ZeitschriftPulmonary Circulation

Bandnummer9

Heftnummer2

ISSN2045-8932

eISSN2045-8940

Open Access StatusGold

DOI Linkhttps://doi.org/10.1177/2045894018805406

VerlagWiley


Abstract
Pulmonary arterial hypertension (PAH) can be found in patients suffering from a loss-of-function mutation of the gene encoding for the activin receptor-like kinase 1 (ALK-1), a bone morphogenetic protein (BMP) type 1 receptor. Interestingly, ALK-1 mutations also lead to hereditary hemorrhagic telangiectasia (HHT), an autosomal dominant disease characterized by arteriovenous malformations (AVMs) leading to potentially life-threatening bleeding complications such as epistaxis. Current therapeutic options for both diseases are limited and often only temporary or accompanied by severe side effects. Here, we report of a patient with a mutation of the ALK-1 gene suffering from both HHT and PAH. Recently, it was shown that tacrolimus increased ALK-1 signaling and had beneficial effects in selected end-stage PAH patients. We thus hypothesized that treatment with tacrolimus may prevent disease progression in this patient. Surprisingly, treatment with low-dose tacrolimus dramatically improved his HHT-associated epistaxis but did not attenuate progression of PAH.



Zitierstile

Harvard-ZitierstilSommer, N., Droege, F., Gamen, K., Geisthoff, U., Gall, H., Tello, K., et al. (2018) Treatment with low-dose tacrolimus inhibits bleeding complications in a patient with hereditary hemorrhagic telangiectasia and pulmonary arterial hypertension, Pulmonary Circulation, 9(2), Article 2045894018805406. https://doi.org/10.1177/2045894018805406

APA-ZitierstilSommer, N., Droege, F., Gamen, K., Geisthoff, U., Gall, H., Tello, K., Richter, M., Deubner, L., Schmiedel, R., Hecker, M., Spiekerkoetter, E., Wirsching, K., Seeger, W., Ghofrani, H., & Pullamsetti, S. (2018). Treatment with low-dose tacrolimus inhibits bleeding complications in a patient with hereditary hemorrhagic telangiectasia and pulmonary arterial hypertension. Pulmonary Circulation. 9(2), Article 2045894018805406. https://doi.org/10.1177/2045894018805406



Schlagwörter


ALK-1 mutationFK506Morbus OslerRESCUEStacrolimusVEGF


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