Hyperdynamic circulation in cirrhosis: a role for nitric oxide?
Hypotension, low systemic vascular resistance, and a reduced sensitivity to vasoconstrictors are features of cirrhosis. These cardiovascular changes might be the result of increased synthesis of a vasodilator. Nitric oxide (NO), a potent vasodilator, is synthesised in and released from peripheral blood-vessels in man. Studies in animals indicate that bacterial endotoxin and cytokines induce NO synthase expression in vessel walls, with sustained NO release and consequent hypotension. Endotoxaemia is a common feature of cirrhosis; persistent induction of NO synthase may account for the associated haemodynamic changes.
Vallance
P
P
Wellcome Research Laboratories, Langley Court, Beckenham, Kent, UK.
Moncada
S
S
D000594:Amino Acid Oxidoreductases / Q000037:antagonists & inhibitors / Q000096:biosynthesis*; D004730:Endothelium, Vascular / Q000378:metabolism; D004731:Endotoxins / Q000097:blood; D006439:Hemodynamics; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000378:metabolism / Q000503:physiopathology*; D009569:Nitric Oxide / Q000378:metabolism*; D019001:Nitric Oxide Synthase; D014664:Vasodilation / Q000187:drug effects
D004731:Endotoxins; D009569:Nitric Oxide; D019001:Nitric Oxide Synthase; D000594:Amino Acid Oxidoreductases