Effect of prostaglandin E1 in collagen disease patients with inflammatory skin ulcer.

UNLABELLED: Clinical, physiological and biochemical studies of PGE1 were done in a series of collagen disease patients with skin ulcer, in a foot varix patient with skin ulcer as a non-inflammatory skin ulcer control, and in two diabetics without skin ulcer as no skin ulcer controls. Intravenous infusions of prostaglandin E1 (PGE1) were given continuously at the dose of 1 ng/kg/min for 72 hours. Blood samples were collected from the cubital vein, before, during, immediately after and at seven days after PGE1 therapy. Platelet aggregations were studied by light transmittance (PRP: modified by Born's method; whole blood: modified by Tohjima's method). Platelet iPGE (immunoreactive PGE-like material) levels were assayed by radio-immunoassay. Essential fatty acid compositions of plasma, platelet and red cells, were analysed by gas chromatography. Results were as follows: (1) in all cases, complete healing of skin ulcers was observed; (2) In most cases, skin temperature increased during PGE1 treatment; (3) Platelet aggregation was higher during PGE1 treatment than before and was higher in PRP than in whole blood during PGE1 treatment; (4) The platelet basal iPGE levels were significantly decreased by PGE1 (P less than 0.025); (5) The plasma and platelet linoleic acid levels were significantly higher than before PGE1 treatment (plasma: P less than 0.05, platelets: P less than 0.025); (6) Thrombocytosis of one case of MRA was healed by the second PGE1 treatment.

CONCLUSION: The inflammatory skin ulcers in collagen diseases were healed completely by continuous intravenous infusion of PGE1. This effect might be brought about by the suppression of PG metabolism, especially in platelets.