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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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. |
format | Online Article Text |
id | pubmed-9917703 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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