Journal
BMC MEDICINE
Volume 20, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s12916-022-02686-6
Keywords
Nitric oxide generator; Inhalation therapy; Pulmonary artery hypertension
Categories
Funding
- National Natural Science Foundation of China
- Shanghai Outstanding Medical Academic Leader Program [U20A2018]
- Shanghai Sailing Program [2019LJ22]
- Shanghai Chenguang Program [20YF1428700]
- Shanghai Pujiang Program [20CG23]
- [22PJ1410100]
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This study developed a novel portable device to produce nitric oxide (NO) for in-home inhalation therapy in patients with pulmonary artery hypertension (PAH). The device effectively reduced pulmonary arterial pressure and pulmonary vascular resistance in a pig model of PAH without causing major physiologic disruptions. This research paves the way for future clinical trials in PAH patients and other cardiopulmonary conditions.
BackgroundInhaled NO is a selective pulmonary vasodilator proven to be therapeutic for patients with pulmonary artery hypertension (PAH). The most common NO delivery system in clinical practice is cylinder-based, but unfortunately limited by its high costs, complicated delivery, and the requirement of an extensive supply chain, leaving vast unmet medical needs globally. MethodsTo address the need for rapid, affordable, and safe production of nitric oxide (NO) for in-home inhalation therapy in patients with PAH. We developed a novel portable device to derive NO from a nitrite complex solution with a copper(II)-ligand catalyst, and further examined its effectiveness in a porcine model of PAH. This model was established by using female Bama miniature pig and induced by monocrotaline (MCT) administration. ResultsThis generator could rapidly and safely produce therapeutic NO at concentrations ranging from 0 to 100 parts per million (ppm) with the least disproportionated nitrogen dioxide (NO2) and byproducts. It could effectively alleviate pulmonary arterial pressure (PAP) and pulmonary vascular resistance (PVR) in piglets with PAH, without causing major physiologic disruptions. ConclusionsOur electrochemical NO generator is able to produce the desired NO doses for pulmonary vasodilation in a safe and sustainable way, with low costs, which paves the way for its subsequent clinical trials in the patient with PAH and other common cardiopulmonary conditions with a high disease burden around the world.
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