title: Plasma cytokines and portopulmonary hypertension in patients with cirrhosis waiting for orthotopic liver transplantation.
abstract: 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.
authors.affiliation: Liver Unit, Azienda Ospedaliera San Camillo, Forlanini, Rome, Italy. adriano.pellicelli@tiscali.it
authors.forename: Adriano M
authors.initials: AM
authors.lastname: Pellicelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Barbaro
authors.forename: Claudio
authors.initials: C
authors.lastname: Puoti
authors.forename: Paolo
authors.initials: P
authors.lastname: Guarascio
authors.forename: Elena Angela
authors.initials: EA
authors.lastname: Lusi
authors.forename: Lia
authors.initials: L
authors.lastname: Bellis
authors.forename: Cecilia
authors.initials: C
authors.lastname: D'Ambrosio
authors.forename: Roberto
authors.initials: R
authors.lastname: Villani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vennarecci
authors.forename: Gianluca
authors.initials: G
authors.lastname: Liotta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ettore
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Andreoli
mesh_terms: 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
chemical_list: D016207:Cytokines; D019332:Endothelin-1; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha