Plasma cytokines and portopulmonary hypertension in patients with cirrhosis waiting for orthotopic liver transplantation.
Portopulmonary hypertension (PPHTN) is a rare complication in patients with portal hypertension. A role of endothelin 1 (ET-1) and other cytokines was demonstrated in primary pulmonary hypertension but not in PPHTN. We evaluated the possible role of ET-1, interleukin 6 (IL-6), interleukin 1β (IL-1β), and tumor necrosis factor alpha (TNF-α) in the pathogenesis of PPHTN. Plasmatic concentrations of ET-1, IL-6, IL-1β, and TNF-α were measured in patients with pulmonary systolic arterial pressure (PAPs) >30 mm Hg and in patients with cirrhosis. In all, Six out of 11 patients with PAPs >30 mm Hg had PPHTN on right heart catheterization. The remaining 10 patients had an hyperdynamic circulation (HC). In PPHTN patients, ET-1 and IL-6 were significantly higher compared with HC and patients with cirrhosis. Endothelin 1 and IL-6 could be implicated in the pathogenesis of PPHTN. On the basis of these results, ET-1 receptor antagonists or anti-IL-6 could have a rationale in the treatment of PPHTN.
Pellicelli
Adriano M
AM
Liver Unit, Azienda Ospedaliera San Camillo, Forlanini, Rome, Italy. adriano.pellicelli@tiscali.it
Barbaro
Giuseppe
G
Puoti
Claudio
C
Guarascio
Paolo
P
Lusi
Elena Angela
EA
Bellis
Lia
L
D'Ambrosio
Cecilia
C
Villani
Roberto
R
Vennarecci
Giovanni
G
Liotta
Gianluca
G
Ettore
Giuseppe
G
Andreoli
Arnaldo
A
D006328:Cardiac Catheterization; D016207:Cytokines / Q000097:blood*; D018618:Echocardiography, Doppler, Color; D019332:Endothelin-1 / Q000097:blood; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood / Q000601:surgery*; D016031:Liver Transplantation; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D016207:Cytokines; D019332:Endothelin-1; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha