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Review
. 2014 Jun 7;14(6):e18625.
doi: 10.5812/hepatmon.18625. eCollection 2014 Jun.

Portal hypertension as immune mediate disease

Sara Manti  1 , Lucia Marseglia  1 , Gabriella D'Angelo  1 , Martina Filippelli  1 , Caterina Cuppari  1 , Eloisa Gitto  1 , Claudio Romano  1 , Teresa Arrigo  1 , Carmelo Salpietro  1
Affiliations
Review

Portal hypertension as immune mediate disease

Sara Manti et al. Hepat Mon. .

Abstract

Context: Portal Hypertension (PH) is a progressive complication due to chronic liver disease. In addition to pathophysiologic changes in the micro-circulation, in PH are established fibrous tissue (periportal fibrous septal) and regenerative hyperplastic nodules (from micro- to macro-nodules) promoting hepatic architectural distortion.

Evidence acquisition: A literature search of electronic databases was undertaken for the major studies published from 1981 to today. The databases searched were: PubMed, EMBASE, Orphanet, Midline and Cochrane Library. We used the keywords: "portal hypertension, children, immune system, endocrine system, liver fibrosis".

Results: It is believed that PH results from three "phenotype": ischemia-reperfusion, involving nervous system (NS); edema and oxidative damage, involving immune system; inflammation and angiogenesis, involving endocrine system. However, its exact cause still underdiagnosed and unknown.

Conclusions: PH is a dynamic and potentially reversible process. Researchers have tried to demonstrate mechanisms underlying PH and its related-complications. This review focuses on the current knowledge regarding the pathogenesis, and immune, endocrine-metabolic factors of disease. The strong positive association between immune system and development of PH could be efficient to identify non-invasive markers of disease, to modify prognosis of PH, and to development and application of specific and individual anti-inflammatory therapy.

Keywords: Children; Endocrine System; Immune System; Liver Fibrosis; Portal Hypertension.

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