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Possible Treatment Strategies for Portal Hypertension in Liver Cirrhosis

Research paper by Robert Schierwagen, Frank Erhard Uschner; Sabine Klein; Jonel Trebicka

Indexed on: 09 Nov '16Published on: 27 Oct '16Published in: Current hepatitis reports



Abstract

Abstract Purpose of the Review Chronic liver injury leading to fibrosis and complicated by portal hypertension is an emerging burden for health systems worldwide, but current treatments are few and poorly effective. Therefore, this review aims to present diverse potential treatment approaches that are currently under investigation or on their way to clinical use. Recent Findings These options involve statins, the renin-angiotensin system and their downstream effectors, the anticoagulation system, farnesoid-x receptor agonism, and various other targets. Summary Since activated hepatic stellate cells play a pivotal role in both fibrogenesis and portal hypertension, most of these potential treatment approaches target directly or indirectly this profibrotic and procontractile cells in liver fibrosis with portal hypertension. Special focus should be paid to cell-specific treatments to minimize side effects and systemic complications in treatment of liver fibrosis and portal hypertension. Abstract Purpose of the Review Chronic liver injury leading to fibrosis and complicated by portal hypertension is an emerging burden for health systems worldwide, but current treatments are few and poorly effective. Therefore, this review aims to present diverse potential treatment approaches that are currently under investigation or on their way to clinical use. Purpose of the ReviewChronic liver injury leading to fibrosis and complicated by portal hypertension is an emerging burden for health systems worldwide, but current treatments are few and poorly effective. Therefore, this review aims to present diverse potential treatment approaches that are currently under investigation or on their way to clinical use. Recent Findings These options involve statins, the renin-angiotensin system and their downstream effectors, the anticoagulation system, farnesoid-x receptor agonism, and various other targets. Recent FindingsThese options involve statins, the renin-angiotensin system and their downstream effectors, the anticoagulation system, farnesoid-x receptor agonism, and various other targets. Summary Since activated hepatic stellate cells play a pivotal role in both fibrogenesis and portal hypertension, most of these potential treatment approaches target directly or indirectly this profibrotic and procontractile cells in liver fibrosis with portal hypertension. Special focus should be paid to cell-specific treatments to minimize side effects and systemic complications in treatment of liver fibrosis and portal hypertension. SummarySince activated hepatic stellate cells play a pivotal role in both fibrogenesis and portal hypertension, most of these potential treatment approaches target directly or indirectly this profibrotic and procontractile cells in liver fibrosis with portal hypertension. Special focus should be paid to cell-specific treatments to minimize side effects and systemic complications in treatment of liver fibrosis and portal hypertension.