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. 2021 Aug 25;16(8):e0256473.
doi: 10.1371/journal.pone.0256473. eCollection 2021.

Role of circulating angiogenin levels in portal hypertension and TIPS

Alexander Queck  1 , Frank E Uschner  1 , Philip G Ferstl  1 , Martin Schulz  1 , Maximilian J Brol  1 , Michael Praktiknjo  2 , Robert Schierwagen  1 , Sabine Klein  1 , Christian P Strassburg  2 , Carsten Meyer  3 , Christian Jansen  2 , Marie-Luise Berres  4 , Jonel Trebicka  1   5
Affiliations

Role of circulating angiogenin levels in portal hypertension and TIPS

Alexander Queck et al. PLoS One. .

Abstract

Background: Pathogenesis of portal hypertension is multifactorial and includes pathologic intrahepatic angiogenesis, whereby TIPS insertion is an effective therapy of portal hypertension associated complications. While angiogenin is a potent contributor to angiogenesis in general, little is known about its impact on TIPS function over time.

Methods: In a total of 118 samples from 47 patients, angiogenin concentrations were measured in portal and inferior caval vein plasma at TIPS insertion (each blood compartment n = 23) or angiographic intervention after TIPS (each blood compartment n = 36) and its relationship with patient outcome was investigated.

Results: Angiogenin levels in the inferior caval vein were significantly higher compared to the portal vein (P = 0.048). Ten to 14 days after TIPS, inferior caval vein angiogenin level correlated inversely with the portal systemic pressure gradient (P<0.001), measured invasively during control angiography. Moreover, patients with TIPS revision during this angiography, showed significantly lower angiogenin level in the inferior caval vein compared to patients without TIPS dysfunction (P = 0.01).

Conclusion: In cirrhosis patients with complications of severe portal hypertension, circulating levels of angiogenin are derived from the injured liver. Moreover, angiogenin levels in the inferior caval vein after TIPS may predict TIPS dysfunction.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Portal and inferior caval vein levels of angiogenin at TIPS insertion.
For statistical analysis, the paired t-test was used (P = 0.048) and presented as scatter plot. TIPS: Transjugular intrahepatic portosystemic shunt. n = 23.
Fig 2
Fig 2. Angiogenin levels in the inferior caval vein during follow-up angiography.
Differences between inferior caval vein angiogenin levels in dependency of the need for TIPS revision at control angiography (P = 0.01). For statistical analysis, the unpaired t-test was used and presented as scatter plot with mean and standard error of the mean. TIPS: Transjugular intrahepatic portosystemic shunt. n = 36.
Fig 3
Fig 3. AUROC of angiogenin for TIPS dysfunction.
The area under the ROC curve of angiogenin for TIPS dysfunction was 0.74 (0.6–0.9); P = 0.01. TIPS: Transjugular intrahepatic portosystemic shunt. n = 36.
Fig 4
Fig 4. Correlation between angiogenin level in the inferior caval vein at follow-up angiography and portal hepatic pressure gradient.
Pearson’s correlation test was used for analysis of correlations between portal hepatic pressure gradient and inferior caval vein angiogenin levels at follow up angiography. TIPS: Transjugular intrahepatic portosystemic shunt. n = 36.
Fig 5
Fig 5. Correlation between inferior caval vein angiogenin concentrations and systemic white blood cell count at control angiography.
Pearson’s correlation test was used for analysis of correlations between systemic WBC and inferior caval vein angiogenin level during control angiography. WBC: White blood cell count. n = 34.
See this image and copyright information in PMC

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