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Schroeder T, Piantadosi CA, Natoli MJ, Autmizguine J, Cohen-Wolkowieczs M, Hamilton KL, Bell C, Klawitter J, Christians U, Irwin DC, Noveck RJ. Safety and Ergogenic Properties of Combined Aminophylline and Ambrisentan in Hypoxia. Clin Pharmacol Ther 2017; 103:888-898. [PMID: 28857147 PMCID: PMC5947522 DOI: 10.1002/cpt.860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 08/14/2017] [Accepted: 08/16/2017] [Indexed: 01/24/2023]
Abstract
We hypothesized that concomitant pharmacological inhibition of the endothelin and adenosine pathway is safe and improves exercise performance in hypoxic humans, via a mechanism that does not involve augmentation of blood oxygenation. To test this hypothesis, we established safety and drug interactions for aminophylline (500 mg) plus ambrisentan (5 mg) in normoxic volunteers. Subsequently, a placebo-controlled study was employed to test the combination in healthy resting and exercising volunteers at simulated altitude (4,267 m). No serious adverse events occurred. Drug interaction was minimal or absent. Aminophylline alleviated hypoxia-induced headaches. Aminophylline, ambrisentan, and their combination all significantly (P < 0.05 vs. placebo) improved submaximal hypoxic exercise performance (19.5, 20.6, and 19.1% >placebo). Single-dose ambrisentan increased blood oxygenation in resting, hypoxic subjects. We conclude that combined aminophylline and ambrisentan offer promise to safely increase exercise capacity in hypoxemic humans without relying on increasing blood oxygen availability.
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Affiliation(s)
| | - Claude A Piantadosi
- Hyperbaric Center, Duke University Medical Center, Durham, North Carolina, USA
| | - Michael J Natoli
- Hyperbaric Center, Duke University Medical Center, Durham, North Carolina, USA
| | - Julie Autmizguine
- Department of Pharmacology, University of Montreal, Montreal, Quebec, Canada
| | - Michael Cohen-Wolkowieczs
- Duke Early Phase Clinical Research Unit, Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Karyn L Hamilton
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
| | - Christopher Bell
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
| | - Jelena Klawitter
- iC42 Integrated Solutions in Clinical Research and Development, University of Colorado, Bioscience East, Aurora, Colorado, USA
| | - Uwe Christians
- iC42 Integrated Solutions in Clinical Research and Development, University of Colorado, Bioscience East, Aurora, Colorado, USA
| | - David C Irwin
- Department of Medicine, University of Colorado Denver Anschutz Campus, Aurora, Colorado, USA
| | - Robert J Noveck
- Hyperbaric Center, Duke University Medical Center, Durham, North Carolina, USA
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