Overlooked subclinical portal hypertension in non-cirrhotic NAFLD: Is it real and how to measure it?

Baffy, Gyorgy; Bosch, Jaime (2022). Overlooked subclinical portal hypertension in non-cirrhotic NAFLD: Is it real and how to measure it? Journal of hepatology, 76(2), pp. 458-463. Elsevier 10.1016/j.jhep.2021.09.029

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Clinical and experimental advances related to the detection, magnitude and pathobiology of subclinical portal hypertension in non-alcoholic fatty liver disease (NAFLD), primarily observed in the presence of non-alcoholic steatohepatitis (NASH), prompt us to revisit current disease paradigms. Hepatic venous pressure gradient (HVPG) has been reported to underestimate portal pressure in NASH-related cirrhosis, while inaccuracy is more likely in non-cirrhotic livers, indicating a potential need for new and preferably non-invasive methods of measurement. Although clinically significant portal hypertension (HVPG ≥10 mmHg) retains its prognostic significance in NASH, subclinical portal hypertension (HVPG 6.0-9.5 mmHg) has been repeatedly detected in patients with NAFLD in the absence of cirrhosis or even significant fibrosis whereas the impact of these findings on disease outcomes remains unclear. Mechanocrine signalling pathways in various types of liver cell reveal a molecular basis for the adverse effects of subclinical portal hypertension and suggest a bidirectional relationship between portal pressure and fibrosis. These findings may guide efforts to improve risk assessment and identify novel therapeutic targets in NAFLD.

Item Type:

Journal Article (Review Article)

Division/Institute:

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

UniBE Contributor:

Bosch Genover, Jaime

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1600-0641

Publisher:

Elsevier

Language:

English

Submitter:

Rahel Fuhrer

Date Deposited:

10 Jan 2022 15:29

Last Modified:

02 Mar 2023 23:35

Publisher DOI:

10.1016/j.jhep.2021.09.029

PubMed ID:

34606912

Uncontrolled Keywords:

hepatic vein catheterization hepatic vein pressure gradient mechanocrine signaling nonalcoholic fatty liver disease portal pressure gradient

BORIS DOI:

10.48350/162233

URI:

https://boris.unibe.ch/id/eprint/162233

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