Читать книгу Gas Biology Research in Clinical Practice - Группа авторов - Страница 33

Medical research must be ultimately conducted for human health benefits. Possible therapeutic opportunities for medical gases are shown in table 1. Although every experimental success might not be transferable to standard clinical practice in the near future, the sophisticated experimental concepts of gas inhalation therapy for a medical condition can be considered to be an important step toward clinical application. The medical gas research is relatively unexplored with a short history. Appropriately designed randomized controlled trials with patient-important outcomes, such as improvement of functions of target organs, decreased intensive care unit and hospital days, and decreased cost of therapy, are sorely needed to establish the role of medical gas therapy in patients with disease, associated with the benefits over preexisting standard therapy. At this moment, INOmax^®, NO gas for inhalation therapy, is a United States Food and Drug Administration (FDA)-approved drug for the treatment of hypoxic respiratory failure in term and near-term newborns. The drug is also approved by regulatory authorities and used in the clinical setting in Europe, Australia, Asia and Latin America. A European clinical study revealed that inhalation of 100-125 ppm CO by patients with chronic obstructive pulmonary disease in a stable phase was feasible and led to trends in reduction of sputum eosinophils and improvement of responsiveness to methacholine [5]. In the USA, a single-blind, placebo-controlled, dose-escalating phase 2 study of inhaled CO in patients receiving renal transplants is currently conducted using Covox^®, a device for CO inhalation. The primary endpoint of the study is to evaluate the safety and tolerability of increasing CO dose levels when administered as an inhaled gas to kidney transplant patients over the course of 1 h in an acute hospital setting. No matter how much time and money are spent, the successful development of a medical gas therapy, as a new therapeutic tool, is by no means a certainty. Researchers and clinicians should be dedicating effort into the clinically feasible use of medical gas that fulfills the unmet medical needs at the frontline of healthcare.