TY - JOUR
T1 - Evolution in the understanding of the pathophysiological basis of portal hypertension
T2 - How changes in paradigm are leading to successful new treatments
AU - Bosch, Jaume
AU - Groszmann, Roberto J.
AU - Shah, Vijay H.
N1 - Publisher Copyright:
© 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
PY - 2015
Y1 - 2015
N2 - Among the common complication of cirrhosis portal hypertension witnessed a major improvement of prognosis during the past decades. Principally due to the introduction of rational treatments based on new pathophysiological paradigms (concepts of thought) developed in the 1980s. The best example being the use of non-selective beta-blockers and of vasopressin analogs, somatostatin, and its analogs. Further refinement in the knowledge of the molecular mechanisms involved in the regulation of both the splanchnic and hepatic circulation has led to the emergence of new treatments, which are based on evidence that show not only structural but also vasoactive components increase the hepatic vascular resistance, as well as of angiogenesis. This knowledge and future improvements will most likely result in more effective treatment of portal hypertension and effective prevention of its complications in early stages.
AB - Among the common complication of cirrhosis portal hypertension witnessed a major improvement of prognosis during the past decades. Principally due to the introduction of rational treatments based on new pathophysiological paradigms (concepts of thought) developed in the 1980s. The best example being the use of non-selective beta-blockers and of vasopressin analogs, somatostatin, and its analogs. Further refinement in the knowledge of the molecular mechanisms involved in the regulation of both the splanchnic and hepatic circulation has led to the emergence of new treatments, which are based on evidence that show not only structural but also vasoactive components increase the hepatic vascular resistance, as well as of angiogenesis. This knowledge and future improvements will most likely result in more effective treatment of portal hypertension and effective prevention of its complications in early stages.
KW - Endothelial dysfunction
KW - Hepatic stellate cells
KW - Hyperdynamic syndrome
KW - Liver sinusoidal endothelial cells
KW - Portal pressure
KW - Splanchnic vasodilation
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U2 - 10.1016/j.jhep.2015.01.003
DO - 10.1016/j.jhep.2015.01.003
M3 - Review article
C2 - 25920081
AN - SCOPUS:84943381123
SN - 0168-8278
VL - 62
SP - S121-S130
JO - Journal of hepatology
JF - Journal of hepatology
IS - S1
ER -