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OBJECTIVE The pharmacological effects of iontophoretically applied prostaglandin E1 (PGE1) on the peripheral microcirculation were investigated. METHODS PGE1 concentrations permeated through hairless mouse skin iontophoretically were measured by HPLC at hourly intervals. 19 patients with arteriosclerosis obliterans were given PGE1 (20 microg) iontophoretically on the dorsum of the foot. As a control, normal saline was applied iontophoretically on another day. The increase rate in cutaneous blood flow as measured by laser Doppler flux (LDF) level was investigated. 5 of these 19 patients received PGE1 (20 microg) solution intravenously on another day. The increase rate in cutaneous blood flow as measured by laser Doppler flux (LDF) level was compared between iontophoresis and intravenous drip infusion. RESULTS PGE1 was transported across hairless mouse skin with iontophoresis in a time-dependent manner, while it did not permeate by passive transport. The percent increase in LDF level was significantly higher in the PGE1 group than in the control group(32.7+/-20.2% vs. 10.3+/-15.5%, p.001). The percentual increase in LDF level was significantly higher with iontophoresis than with intravenous drip infusion (43.7+/-19.5% vs. 11.7+/-28.3%, p < 0.05). CONCLUSIONS The results indicated that iontophoretically applied PGE1 was effective in improving the impaired microcirculation due to peripheral arterial occlusive disease. This technique may be useful in managing severely ischemic legs.
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