CURRENT RESEARCH & DEVELOPMENT

We are researching therapies that aim to change critical care in the following areas

 

Inhaled nitric oxide in bronchopulmonary dysplasia (BPD) in premature infants
Each year approximately 500,000 babies are born prematurely in the US. Of these, about 10% will have lungs that are so poorly developed, they will require oxygen therapy and mechanical ventilation. Most of these infants have immature lungs, and a portion of these ventilated babies develop scarring of the lungs, leading to the development of BPD. BPD remains a significant cause of morbidity in premature newborns.1-4

 

Inhaled nitric oxide in pulmonary arterial hypertension (PAH)
Pulmonary arterial hypertension (PAH) is a life-threatening, progressive disorder characterized by abnormally high blood pressure, or hypertension, in the pulmonary artery, the blood vessel that carries blood from the heart to the lungs.5-7 Shortness of breath during exertion and fainting spells are the most common symptoms of PAH. As the condition worsens, patients may experience additional symptoms, such as dizziness, swelling of the ankles or legs, chest pain, or a racing pulse.6,8 According to a published article, the current 1-year survival for patients diagnosed with PAH is approximately 84%, with 67% surviving at 3 years, and 58% surviving at 5 years.7

 

Inhaled nitric oxide in chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease (COPD) refers to a group of progressive lung conditions characterized by airflow limitation that is not fully reversible. These conditions include emphysema, chronic bronchitis, and small airways disease.9-11 A common complication of COPD, pulmonary hypertension is associated with shorter survival and worse clinical evolution. To date, long-term oxygen administration is the only treatment to slow its progression. However, pulmonary artery pressure rarely returns to normal values, and the structural abnormalities of pulmonary vessels remain unaltered. Current vasodilators are not recommended because of their minimal clinical efficacy and their impairment of pulmonary gas exchange.12 Encouragingly, research shows preliminary evidence that long-term, pulsed administration of inhaled nitric oxide, as may be delivered by a device such as the INOpulse DS, may decrease pulmonary hypertension in patients with COPD without adversely impacting gas exchange.13 While the severity of the disease course varies among the different conditions, COPD affects more than 16 million people in the United States alone and is recognized as the fourth leading cause of death nationwide.9,10

 

Terlipressin for injection in patients with hepatorenal syndrome Type 1
Hepatorenal syndrome (HRS) Type 1 is a rare and often fatal condition of advancing kidney failure in patients with cirrhosis or other severe liver diseases. In many of these patients, a successful liver transplant is their only hope to reverse HRS Type 1 and restore normal kidney function. Currently there is no FDA-approved pharmacological agent on the market to reverse HRS Type 1. Studies have shown that terlipressin may help patients achieve HRS reversal by redistributing blood flow to the kidneys.14,15

 

Injection of a resorbable liquid polymer (IK-5001) following acute myocardial infarction

Following a myocardial infarction, adverse remodeling of the left ventricle of the heart can result in its enlargement and deformation and lead to subsequent congestive heart failure. Research in animal models suggests that injection of IK-5001 may prevent cardiac remodeling and subsequent congestive heart failure following acute myocardial infarction.16

References
  1. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163(7):1723-1729.
  2. Schmidt B, Asztalos EV, Roberts RS, Robertson CM, Sauve RS, Whitfield MF. Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months: results from the trial of indomethacin prophylaxis in preterms. JAMA. 2003;289(9):1124-1129.
  3. Roberts JD Jr, Chiche JD, Weimann J, Steudel W, Zapol WM, Bloch KD. Nitric oxide inhalation decreases pulmonary artery remodeling in the injured lungs of rat pups. Circ Res. 2000;87(2):140-145.
  4. McCurnin DC, Pierce RA, Chang LY, et al. Inhaled NO improves early pulmonary function and modifies lung growth and elastin deposition in a baboon model of neonatal chronic lung disease. Am J Physiol Lung Cell Mol Physiol. 2005;288:L450-L459.
  5. Anderson J, Nawarskas JJ. Pharmacotherapeutic management of pulmonary arterial hypertension. Cardiol Rev. 2010;18(3):148-162.
  6. McLaughlin VV, Archer SL, Badesch DB, et al. ACCF/AHA 2009 expert consensus document on pulmonary hypertension: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association. J Am Coll Cardiol. 2009;53(17):1573-1619.
  7. Thenappan T, Shah SJ, Rich S, Gomberg-Maitland M. A USA-based registry for pulmonary arterial hypertension: 1982-2006. Eur Respir J. 2007;30(6):1103-1110.
  8. McLaughlin VV, McGoon MD. Pulmonary arterial hypertension. Circulation. 2006;114(13):1417-1431.
  9. Reilly JJ Jr, Silverman EK, Shapiro SD. Chronic obstructive pulmonary disease. In: Fauci AS, Braunwald E, Kaspar DL, et al, eds. Harrison’s Principles of Internal Medicine. 17th ed. New York, NY: McGraw Hill Medical; 2008;1635-1643.
  10. Rabe KF, Hurd S, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention
    of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2007;176(6):532-555.
  11. Chronic obstructive pulmonary disease (COPD). Centers for Disease Control and Prevention Web site. http://www.cdc.gov/copd/index.htm. Accessed August 23, 2011.
  12. Barberà JA, Peinado VI, Santos S.  Pulmanary hypertension in chronic obstructive pulmonary disease. Eur Respir J. 2003;21(5):892-905.
  13. Vonbank K, Ziesche R, Higenbottam TW, et al. Controlled prospective randomised trial on the effects on pulmonary haemodynamics of the ambulatory long term use of nitric oxide and oxygen in patients with severe COPD. Thorax. 2003;58(4):289-293.
  14. Sanyal AJ, Boyer T, Garcia-Tsao G, et al. A randomized, prospective, double-blind, placebo-controlled trial of terlipressin for type 1 hepatorenal syndrome. Gastroenterology. 2008;134(5):1360-1368.
  15. Martín-Llahí M, Pépin MN, Guevara M, et al. Terlipressin and albumin vs albumin in patients with cirrhosis and hepatorenal syndrome: a randomized study. Gastroenterology. 2008;134(5):1352-1359.
  16. Landa N, Miller L, Feinberg MS, et al. Effect of injectable alginate implant on cardiac remodeling and function after recent and old infarcts in rat. Circulation. 2008;117(11):1388-1396.

 

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