Clinical Science (2002) 103, 345–346 (Printed in Great Britain) Fuad LECHIN*, Bertha VAN DER DIJS* and Alex E. LECHIN† *Instituto de Medicina Experimental, Universidad Central de Venezuela, Apartado 80.983, Caracas 1080-A, Venezuela, and †Department of Clinical Sciences, University of Houston, 4800 Calhoun, Houston, TX 77204, U.S.A.
We read with great interest the review article by Strange
REFERENCES
et al. [1]. With respect to it, we would like add someadditional information. In 1994 we presented results
1 Strange, J. W., Wharton, J., Phillips, P. G. and Wilkins,
dealing with the increasing levels of catecholamines and
M. R. (2002) Recent insights into the pathogenesis and therapeutics of pulmonary hypertension. Clin. Sci. 102,
plasma free serotonin (f-5HT) during asthma attacks [2].
In 1996 we demonstrated that increased levels of f-5HT
2 Lechin, A. E., Varon, J., van der Dijs, B. and Lechin, F.
(1994) Plasma neurotransmitters, blood pressure and
in plasma during asthma attacks were associated with
heart rate during rest and exercise. Am. J. Respir. Crit.
clinical severity and pulmonary function [3]. In 1998 we
Care Med. 149, A482
published two research papers showing that tianeptine
3 Lechin, F., van der Dijs, B., Orozco, B., Lechin, M. E.
and Lechin, A. E. (1996) Increased levels of free serotonin
(a serotonin-uptake-enhancing drug that reduces plasma
in plasma of symptomatic asthmatic patients. Ann.
f-5HT) provoked a dramatic and sudden decrease of both
Allergy Asthma Immunol. 77, 245–253
4 Lechin, F., van der Dijs, B., Orozco, B., Jara, H., Rada, I.,
clinical rating and f-5HT plasma levels [4,5]. This
Lechin, M. and Lechin, A. E. (1998) The serotonin
successful therapeutic strategy has been applied not only
uptake-enhancing drug tianeptine suppresses asthmaticsymptoms in children : a double-blind, crossover placebo-
to children and adolescents, but also to adults. Up to
controlled study. J. Clin. Pharmacol. 38, 918–925
the present, we have successfully treated some 16 000
5 Lechin, F., van der Dijs, B., Orozco, B., Jara, H., Rada, I.,
asthmatic patients. Twenty four of those patients also
Lechin, M. and Lechin, A. E. (1998) Neuropharmacologictreatment of bronchial asthma with the antidepressant
present with pulmonary hypertension (PH). Absolute
tianeptine : a double-blind, crossover placebo-controlled
normalization of PH was obtained in 19 of the patients.
study. Clin. Pharmacol. Ther. 64, 223–232
6 Lechin, F. (2001) Asthma, asthma medication and
Some preliminary information dealing with this issue has
autonomic nervous system dysfunction.
Clin. Physiol. 21, 723
Finally the fact that buspirone, a 5HT-1A agonist
7 Lechin, F. and van der Dijs, B. (2002) Serotonin and
pulmonary vasoconstriction. J. Appl. Physiol. 92,
which increases plasma f-5HT [10], triggers asthma
attacks and worsens PH patients [11], provides additional
8 Lechin, F., van der Dijs, B. and Lechin, A. E. (2002)
Severe asthma and plasma serotonin. Allergy 57, 258–259
support for the etiopathogenic role of f-5HT in both
9 Lechin, F., van der Dijs, B. and Lechin, M. E. (2002)
bronchial asthma and pulmonary hypertension.
Neurocircuitry and Neuroautonomic Disorders. Reviewsand Therapeutic Strategies. Chapter 12. Basel : Karger AG
10 Lechin, F., van der Dijs, B., Jara, H., Orozco, B., Baez, S.,
Benaim, M., Lechin, M. and Lechin, A. (1998) Effects of buspirone on plasma neurotransmitters in healthy subjects. J. Neural Transm. 105, 561–573
11 Lechin, F. (2000) Central and plasma 5-HT, vagal tone
and airways. Trends Pharmacol. Sci. 21, 425 Key words : bronchial asthma, plasma serotonin, pulmonary hypertension, therapeutics. Correspondence : Dr F. Lechin (e-mail flechin!telcel.net.ve).
# 2002 The Biochemical Society and the Medical Research Society
Julian STRANGE Section on Clinical Pharmacology, Imperial College, Hammersmith Hospital, Du Cane Road, London W12 ONN, U.K.
There is much interest in the role of serotonin (5HT). REFERENCES
Recent animal data has demonstrated the attenuation ofhypoxic-induced pulmonary hypertension (PH) by sero-
1 Eddahibi, S., Raffestin, B., Hanoun, N., Hamon, M. and
tonin transporter (5HTT) inhibitors but interestingly
Adnot, S. (2002) Serotonin transporter inhibitors but notserotonin receptor antagonists protect against chronic
hypoxic pulmonary hypertension in mice. Am. J. Respir.
Also cultured pulmonary artery smooth-muscle cells
Crit. Care Med. 165, A748
2 Eddahibi, S., Humbert, M., Fadel, E. et al. (2002)
from patients with primary PH have increased expression
Hyperplasia of pulmonary artery smooth muscle cells is
of 5HTT compared with normals and this is associated
causally related to overexpression of the serotonin
with the long (L) variant gene polymorphism for the
transporter in primary pulmonary hypertension. Chest 121 (Suppl. 3), S97–S98
5HTT-linked promoter region, suggesting a geneticpredisposition [2].
# 2002 The Biochemical Society and the Medical Research Society
THE CONFLATION OF IHL AND THE LEGAL FRAMEWORK GOVERNING TERRORISM While armed conflict and acts of terrorism are different forms of violence governed by different bodies of law, they have come to be perceived as almost synonymous due to constant conflation in the public domain. The ICRC’s views on the legal classification of what has been called the “war against terrorism” and of the lega
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Clinical Science (2002) 103, 345–346 (Printed in Great Britain)