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Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis

Portal hypertension is the consequence of cirrhosis and results from increased sinusoidal vascular resistance and hepatic blood inflow. Etiological therapies represent the first intervention to prevent a significant increase in portal pressure due to chronic liver damage. However, other superimposed...

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Detalles Bibliográficos
Autores principales: Bitto, Niccolò, Ghigliazza, Gabriele, Lavorato, Stanislao, Caputo, Camilla, La Mura, Vincenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917703/
https://www.ncbi.nlm.nih.gov/pubmed/36769582
http://dx.doi.org/10.3390/jcm12030934
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author Bitto, Niccolò
Ghigliazza, Gabriele
Lavorato, Stanislao
Caputo, Camilla
La Mura, Vincenzo
author_facet Bitto, Niccolò
Ghigliazza, Gabriele
Lavorato, Stanislao
Caputo, Camilla
La Mura, Vincenzo
author_sort Bitto, Niccolò
collection PubMed
description Portal hypertension is the consequence of cirrhosis and results from increased sinusoidal vascular resistance and hepatic blood inflow. Etiological therapies represent the first intervention to prevent a significant increase in portal pressure due to chronic liver damage. However, other superimposed pathophysiological drivers may worsen liver disease, including inflammation, bacterial translocation, endothelial dysfunction, and hyperactivation of hemostasis. These mechanisms can be targeted by a specific class of drugs already used in clinical practice. Albumin, rifaximin, statins, aspirin, and anticoagulants have been tested in cirrhosis and were a topic of discussion in the last Baveno consensus as non-etiological therapies. Based on the pathogenesis of portal hypertension in cirrhosis, our review summarizes the main mechanisms targeted by these drugs as well as the clinical evidence that considers them a valid complementary option to manage patients with cirrhosis and portal hypertension.
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spelling pubmed-99177032023-02-11 Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis Bitto, Niccolò Ghigliazza, Gabriele Lavorato, Stanislao Caputo, Camilla La Mura, Vincenzo J Clin Med Review Portal hypertension is the consequence of cirrhosis and results from increased sinusoidal vascular resistance and hepatic blood inflow. Etiological therapies represent the first intervention to prevent a significant increase in portal pressure due to chronic liver damage. However, other superimposed pathophysiological drivers may worsen liver disease, including inflammation, bacterial translocation, endothelial dysfunction, and hyperactivation of hemostasis. These mechanisms can be targeted by a specific class of drugs already used in clinical practice. Albumin, rifaximin, statins, aspirin, and anticoagulants have been tested in cirrhosis and were a topic of discussion in the last Baveno consensus as non-etiological therapies. Based on the pathogenesis of portal hypertension in cirrhosis, our review summarizes the main mechanisms targeted by these drugs as well as the clinical evidence that considers them a valid complementary option to manage patients with cirrhosis and portal hypertension. MDPI 2023-01-25 /pmc/articles/PMC9917703/ /pubmed/36769582 http://dx.doi.org/10.3390/jcm12030934 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Bitto, Niccolò
Ghigliazza, Gabriele
Lavorato, Stanislao
Caputo, Camilla
La Mura, Vincenzo
Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis
title Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis
title_full Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis
title_fullStr Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis
title_full_unstemmed Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis
title_short Improving Management of Portal Hypertension: The Potential Benefit of Non-Etiological Therapies in Cirrhosis
title_sort improving management of portal hypertension: the potential benefit of non-etiological therapies in cirrhosis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917703/
https://www.ncbi.nlm.nih.gov/pubmed/36769582
http://dx.doi.org/10.3390/jcm12030934
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