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Future therapy of portal hypertension in liver cirrhosis – a guess

In patients with chronic liver disease, portal hypertension is driven by progressive fibrosis and intrahepatic vasoconstriction. Interruption of the initiating and perpetuating etiology—mostly leading to necroinflammation—is possible for several underlying causes, such as autoimmune hepatitis, hepat...

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Autores principales: Sauerbruch, Tilman, Trebicka, Jonel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculty of 1000 Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191223/
https://www.ncbi.nlm.nih.gov/pubmed/25374673
http://dx.doi.org/10.12703/P6-95
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author Sauerbruch, Tilman
Trebicka, Jonel
author_facet Sauerbruch, Tilman
Trebicka, Jonel
author_sort Sauerbruch, Tilman
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description In patients with chronic liver disease, portal hypertension is driven by progressive fibrosis and intrahepatic vasoconstriction. Interruption of the initiating and perpetuating etiology—mostly leading to necroinflammation—is possible for several underlying causes, such as autoimmune hepatitis, hepatitis B virus (HBV) infection, and most recently hepatitis C virus (HCV) infection. Thus, in the long run, lifestyle-related liver damage due to chronic alcoholism or morbid obesity will remain the main factor leading to portal hypertension. Both causes are probably more easily countered by socioeconomic measures than by individual approaches. If chronic liver injury supporting fibrogenesis and portal hypertension cannot be interrupted, a wide variety of tools are available to modulate and reduce intrahepatic resistance and therewith portal hypertension. Many of these have been evaluated in animal models. Also, some well-established drugs, which are used in humans for other indications (for example, statins), are promising if applied early and concomitantly to standard therapy. In the future, more individually tailored strategies must also be considered in line with the spectrum of portal hypertensive complications and risk factors defined by high-throughput analysis of the patient’s genome, transcriptome, metabolome, or microbiome.
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spelling pubmed-41912232014-11-05 Future therapy of portal hypertension in liver cirrhosis – a guess Sauerbruch, Tilman Trebicka, Jonel F1000Prime Rep Review Article In patients with chronic liver disease, portal hypertension is driven by progressive fibrosis and intrahepatic vasoconstriction. Interruption of the initiating and perpetuating etiology—mostly leading to necroinflammation—is possible for several underlying causes, such as autoimmune hepatitis, hepatitis B virus (HBV) infection, and most recently hepatitis C virus (HCV) infection. Thus, in the long run, lifestyle-related liver damage due to chronic alcoholism or morbid obesity will remain the main factor leading to portal hypertension. Both causes are probably more easily countered by socioeconomic measures than by individual approaches. If chronic liver injury supporting fibrogenesis and portal hypertension cannot be interrupted, a wide variety of tools are available to modulate and reduce intrahepatic resistance and therewith portal hypertension. Many of these have been evaluated in animal models. Also, some well-established drugs, which are used in humans for other indications (for example, statins), are promising if applied early and concomitantly to standard therapy. In the future, more individually tailored strategies must also be considered in line with the spectrum of portal hypertensive complications and risk factors defined by high-throughput analysis of the patient’s genome, transcriptome, metabolome, or microbiome. Faculty of 1000 Ltd 2014-10-01 /pmc/articles/PMC4191223/ /pubmed/25374673 http://dx.doi.org/10.12703/P6-95 Text en © 2014 Faculty of 1000 Ltd http://creativecommons.org/licenses/by-nc/3.0/legalcode All F1000Prime Reports articles are distributed under the terms of the Creative Commons Attribution-Non Commercial License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Sauerbruch, Tilman
Trebicka, Jonel
Future therapy of portal hypertension in liver cirrhosis – a guess
title Future therapy of portal hypertension in liver cirrhosis – a guess
title_full Future therapy of portal hypertension in liver cirrhosis – a guess
title_fullStr Future therapy of portal hypertension in liver cirrhosis – a guess
title_full_unstemmed Future therapy of portal hypertension in liver cirrhosis – a guess
title_short Future therapy of portal hypertension in liver cirrhosis – a guess
title_sort future therapy of portal hypertension in liver cirrhosis – a guess
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191223/
https://www.ncbi.nlm.nih.gov/pubmed/25374673
http://dx.doi.org/10.12703/P6-95
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