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What makes non-cirrhotic portal hypertension a common disease in India? Analysis for environmental factors
In India, an unexplained enteropathy is present in a majority of non-cirrhotic intrahepatic portal hypertension (NCIPH) patients. Small intestinal bacterial contamination and tropical enteropathy could trigger inflammatory stimuli and activate the endothelium in the portal venous system. Groundwater...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676844/ https://www.ncbi.nlm.nih.gov/pubmed/31411170 http://dx.doi.org/10.4103/ijmr.IJMR_1405_17 |
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author | Goel, Ashish Ramakrishna, Banumathi Zachariah, Uday Sajith, K.G. Burad, Deepak K. Kodiatte, Thomas A. Keshava, Shyamkumar N. Balasubramanian, K.A. Elias, Elwyn Eapen, C.E. |
author_facet | Goel, Ashish Ramakrishna, Banumathi Zachariah, Uday Sajith, K.G. Burad, Deepak K. Kodiatte, Thomas A. Keshava, Shyamkumar N. Balasubramanian, K.A. Elias, Elwyn Eapen, C.E. |
author_sort | Goel, Ashish |
collection | PubMed |
description | In India, an unexplained enteropathy is present in a majority of non-cirrhotic intrahepatic portal hypertension (NCIPH) patients. Small intestinal bacterial contamination and tropical enteropathy could trigger inflammatory stimuli and activate the endothelium in the portal venous system. Groundwater contaminated with arsenic is an environmental factor of epidemic proportions in large areas of India which has similar consequences. Von Willebrand factor (a sticky protein) expressed by activated endothelium may promote formation of platelet microthrombi and occlusion of intrahepatic portal vein branches leading to NCIPH. Environmental factors linked to suboptimal hygiene and sanitation, which enter through the gastrointestinal (GI) tract, predispose to platelet plugging onto activated endothelium in portal microcirculation. Thus, NCIPH, an example of poverty linked thrombophilia, is a disease mainly affecting the lower socio-economic strata of Indian population. Public health measures to improve sanitation, provide clean drinking water and eliminate arsenic contamination of drinking water are urgently needed. Till such time as these environmental factors are addressed, NCIPH is likely to remain 'an Indian disease'. |
format | Online Article Text |
id | pubmed-6676844 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-66768442019-08-14 What makes non-cirrhotic portal hypertension a common disease in India? Analysis for environmental factors Goel, Ashish Ramakrishna, Banumathi Zachariah, Uday Sajith, K.G. Burad, Deepak K. Kodiatte, Thomas A. Keshava, Shyamkumar N. Balasubramanian, K.A. Elias, Elwyn Eapen, C.E. Indian J Med Res Review Article In India, an unexplained enteropathy is present in a majority of non-cirrhotic intrahepatic portal hypertension (NCIPH) patients. Small intestinal bacterial contamination and tropical enteropathy could trigger inflammatory stimuli and activate the endothelium in the portal venous system. Groundwater contaminated with arsenic is an environmental factor of epidemic proportions in large areas of India which has similar consequences. Von Willebrand factor (a sticky protein) expressed by activated endothelium may promote formation of platelet microthrombi and occlusion of intrahepatic portal vein branches leading to NCIPH. Environmental factors linked to suboptimal hygiene and sanitation, which enter through the gastrointestinal (GI) tract, predispose to platelet plugging onto activated endothelium in portal microcirculation. Thus, NCIPH, an example of poverty linked thrombophilia, is a disease mainly affecting the lower socio-economic strata of Indian population. Public health measures to improve sanitation, provide clean drinking water and eliminate arsenic contamination of drinking water are urgently needed. Till such time as these environmental factors are addressed, NCIPH is likely to remain 'an Indian disease'. Wolters Kluwer - Medknow 2019-04 /pmc/articles/PMC6676844/ /pubmed/31411170 http://dx.doi.org/10.4103/ijmr.IJMR_1405_17 Text en Copyright: © 2019 Indian Journal of Medical Research http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Review Article Goel, Ashish Ramakrishna, Banumathi Zachariah, Uday Sajith, K.G. Burad, Deepak K. Kodiatte, Thomas A. Keshava, Shyamkumar N. Balasubramanian, K.A. Elias, Elwyn Eapen, C.E. What makes non-cirrhotic portal hypertension a common disease in India? Analysis for environmental factors |
title | What makes non-cirrhotic portal hypertension a common disease in India? Analysis for environmental factors |
title_full | What makes non-cirrhotic portal hypertension a common disease in India? Analysis for environmental factors |
title_fullStr | What makes non-cirrhotic portal hypertension a common disease in India? Analysis for environmental factors |
title_full_unstemmed | What makes non-cirrhotic portal hypertension a common disease in India? Analysis for environmental factors |
title_short | What makes non-cirrhotic portal hypertension a common disease in India? Analysis for environmental factors |
title_sort | what makes non-cirrhotic portal hypertension a common disease in india? analysis for environmental factors |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676844/ https://www.ncbi.nlm.nih.gov/pubmed/31411170 http://dx.doi.org/10.4103/ijmr.IJMR_1405_17 |
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