TY - T1的第一个组织病理学的证据irreversible pulmonary vascular disease in dasatinib-induced pulmonary arterial hypertension JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01694-2017 VL - 51 IS - 3 SP - 1701694 AU - Daccord, Cécile AU - Letovanec, Igor AU - Yerly, Patrick AU - Bloch, Jonathan AU - Ogna, Adam AU - Nicod, Laurent P. AU - Aubert, John-David Y1 - 2018/03/01 UR - //www.qdcxjkg.com/content/51/3/1701694.abstract N2 - We read with interest the article by Weatherald et al. [1] on the long-term outcomes of pulmonary arterial hypertension (PAH) induced by dasatinib. The authors reported 21 incident cases of PAH confirmed by right heart catheterisation (RHC) and associated with dasatinib. Although a majority of patients improved after dasatinib discontinuation, PAH persisted in over one-third of cases during long-term follow-up and two additional patients had persistent exercise pulmonary hypertension despite normalisation of resting haemodynamic measures. Similarly, Shah et al. [2] reported 41 cases of dasatinib-induced PAH confirmed by RHC with complete resolution of PAH in only 58% of patients, provided that follow-up RHC or echocardiography was most often not documented. As mentioned by Weatherald et al. [1], these data suggest that dasatinib is likely to cause irreversible pulmonary vascular dysfunction and remodelling. An experimental model in rats and human pulmonary endothelial cells supports this hypothesis as it showed that dasatinib causes dose-dependent pulmonary endothelial dysfunction and apoptosis through the production of mitochondrial reactive oxygen species, a phenomenon that was not observed with imatinib [3]. To date, there is no published evidence of such pathological abnormalities in the human lung. We report the case of a patient who developed dasatinib-induced severe PAH that progressed in spite of drug cessation and aggressive PAH-specific therapy and ultimately underwent lung transplantation.The presence of irreversible pulmonary vascular lesions explains why dasatinib-induced PAH can frequently persist http://ow.ly/MKwI30hRwfc ER -