Montalescot G
Service de cardiologie, hôpital Pitié-Salpêtrière, Paris.
Arch Mal Coeur Vaiss. 1992 Sep;85 Spec No 2:181-3.
Prostaglandins seem to be involved in all stages of the atheromatous process, especially coronary artery disease. This condition is associated with decreased prostacyclin synthesis. Prostacyclin, by the intermediary of cAMP, regulates cholesterol metabolism in the smooth muscle cell by mobilising intracellular cholesterol. Thromboxane is liberated in great quantities in acute coronary syndromes such as myocardial infarction (especially when fibrinolysis is performed) and unstable angina. It is also found in high concentrations in coronary sinus blood during stress tests inducing transient ischaemia in patients with stable angina. There is a relationship between the degree of ischaemia and plasma concentrations of thromboxane whereas prostacyclin levels remain unchanged, causing an imbalance between these two substances during ischaemia. Thromboxane is also responsible for the acute pulmonary vasoconstriction induced by the neutralisation of heparin by protamine. The introduction of molecules modifying the synthesis of these prostaglandins or inhibiting their effects by specifically blocking their receptors should open up new therapeutic possibilities.
前列腺素似乎参与动脉粥样硬化过程的各个阶段，尤其是冠状动脉疾病。这种病症与前列环素合成减少有关。前列环素通过环磷酸腺苷（cAMP）的介导，通过动员细胞内胆固醇来调节平滑肌细胞中的胆固醇代谢。在急性冠状动脉综合征如心肌梗死（特别是在进行纤维蛋白溶解时）和不稳定型心绞痛中，血栓素大量释放。在诱发稳定型心绞痛患者短暂缺血的应激试验期间，冠状动脉窦血中也发现高浓度的血栓素。缺血程度与血栓素血浆浓度之间存在关系，而前列环素水平保持不变，导致缺血期间这两种物质之间失衡。血栓素还负责由鱼精蛋白中和肝素引起的急性肺血管收缩。引入改变这些前列腺素合成或通过特异性阻断其受体抑制其作用的分子应该会开辟新的治疗可能性。
