Emerging therapies for portal hypertension in cirrhosis.

Nair, Harikumar; Berzigotti, Annalisa; Bosch, Jaime (2016). Emerging therapies for portal hypertension in cirrhosis. Expert opinion on emerging drugs, 21(2), pp. 167-181. Taylor & Francis 10.1080/14728214.2016.1184647

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INTRODUCTION Counteracting splanchnic vasodilatation and increased portal-collateral blood flow has been the mainstay for the treatment of portal hypertension (PH) over the past three decades. However, there is still large room for improvement in the treatment of PH. AREAS COVERED The basic mechanism leading to portal hypertension is the increased hepatic vascular resistance to portal blood flow caused by liver structural abnormalities inherent to cirrhosis and increased hepatic vascular tone. Molecules modulating microvascular dysfunction which have undergone preclinical and clinical trials are summarized, potential drug development issues are addressed, and situations relevant to design of clinical trials are considered. EXPERT OPINION Experimental and clinical evidence indicates that molecules modulating liver microvascular dysfunction may allow for 30-40% reduction in portal pressure. Several agents could be utilized in the earlier stages of cirrhosis (antifibrotics, antiangiogenics, etiological therapies) may allow reduction of fibrosis and halt progression of PH. This 'nip at the bud' policy, by combining therapies with existing agents used in advanced phase of cirrhosis and novel agents which could be used in early phase of cirrhotic spectrum, which are likely to hit the market soon would be the future strategy for PH therapy.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine

UniBE Contributor:

Nair, Harikumar; Berzigotti, Annalisa and Bosch, Jaime

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1744-7623

Publisher:

Taylor & Francis

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

05 Apr 2017 14:44

Last Modified:

04 Oct 2017 16:32

Publisher DOI:

10.1080/14728214.2016.1184647

PubMed ID:

27148904

Uncontrolled Keywords:

Hepatic vascular resistance; endothelial dysfunction; hepatic stellate cells; hepatic vein pressure gradient; liver fibrosis; liver sinusoidal endothelial cells; portal pressure; splanchnic circulation

URI:

https://boris.unibe.ch/id/eprint/93588

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