TY -的T1 -维生素D缺乏,一个潜在的cause for insufficient response to sildenafil in pulmonary arterial hypertension JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01204-2021 VL - 58 IS - 5 SP - 2101204 AU - Callejo, María AU - Blanco, Isabel AU - Barberá, Joan Albert AU - Perez-Vizcaino, Francisco Y1 - 2021/11/01 UR - //www.qdcxjkg.com/content/58/5/2101204.abstract N2 - Phosphodiesterase 5 inhibitors (PDE5i), such as sildenafil and tadalafil, are frequently used to treat pulmonary arterial hypertension (PAH) [1]. Combined therapy of PDE5i with drugs acting via other signalling mechanisms, i.e. the endothelin pathway, is currently recommended as it provides better clinical outcomes than monotherapy with PDE5i [1, 2]. The soluble guanylyl cyclase (sGC) stimulator riociguat is an interesting alternative to PDE5i, with a different mode of action but on the same signalling pathway. Recently, the results of the REPLACE study show that, in patients remaining at intermediate risk of 1-year mortality after PDE5i treatment, switching to riociguat is beneficial in terms of clinical improvement and risk status as compared with PDE5i maintenance therapy [3].Vitamin D deficiency causes a reduced response to sildenafil but not to riociguat in rats with PAH. Lower levels of vitamin D were also retrospectively associated to insufficient response to PDE5 inhibitors in PAH patients. https://bit.ly/3rZDcTF ER -