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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!
# 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).
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


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