title: Relationship between tetrahydrobiopterin and portal hypertension in patients with chronic liver disease.
abstract: Tetrahydrobiopterin (BH4) is an essential cofactor in NO synthesis by endothelial nitric oxide synthase (eNOS) enzymes. It has been previously suggested that reduced intrahepatic BH4 results in a decrease in intrahepatic NO and contributes to increased hepatic vascular resistance and portal pressure in animal models of cirrhosis. The main aim of the present study was to evaluate the relationship between BH4 and portal hypertension (PHT). One hundred ninety-three consecutive patients with chronic liver disease were included in the study. Liver biopsy, measurement of BH4 and hepatic venous pressure gradient (HVPG) were performed. Hepatic fibrosis was classified using the Laennec fibrosis scoring system. BH4 levels were determined in homogenized liver tissues of patients using a high performance liquid chromatography (HPLC) system. Statistical analysis was performed to evaluate the relationship between BH4 and HVPG, grade of hepatic fibrosis, clinical stage of cirrhosis, Child-Pugh class. A positive relationship between HVPG and hepatic fibrosis grade, clinical stage of cirrhosis and Child-Pugh class was observed. However, the BH4 level showed no significant correlation with HVPG or clinical features of cirrhosis. BH4 concentration in liver tissue has little relation to the severity of portal hypertension in patients with chronic liver disease.
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Won Ki
authors.identifier: 0000-0002-2229-6936
authors.initials: WK
authors.lastname: Hong
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Kwang Yong
authors.identifier: 0000-0001-8064-3898
authors.initials: KY
authors.lastname: Shim
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Soon Koo
authors.identifier: 0000-0001-6245-2537
authors.initials: SK
authors.lastname: Baik
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Moon Young
authors.identifier: 0000-0002-2501-2206
authors.initials: MY
authors.lastname: Kim
authors.affiliation: Department of Pathology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Mee Yon
authors.identifier: 0000-0002-7955-4211
authors.initials: MY
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Yoon Ok
authors.identifier: 0000-0002-5206-3885
authors.initials: YO
authors.lastname: Jang
authors.affiliation: School of Biological Sciences, Inje University College of Medicine, Gimhae, Korea.
authors.forename: Young Shik
authors.identifier: 0000-0002-8808-4530
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Physiology and Biophysics, Inje University College of Medicine, Busan, Korea.
authors.forename: Jin
authors.identifier: 0000-0003-1859-3425
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of Nursing, Keimyung University College of Nursing, Daegu, Korea.
authors.forename: Gaeun
authors.identifier: 0000-0003-1914-8331
authors.initials: G
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Youn Zoo
authors.identifier: 0000-0002-1064-290X
authors.initials: YZ
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Hye Won
authors.identifier: 0000-0001-5408-8894
authors.initials: HW
authors.lastname: Hwang
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Jin Hyung
authors.identifier: 0000-0002-8152-9541
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Myeong Hun
authors.identifier: 0000-0001-5449-0592
authors.initials: MH
authors.lastname: Chae
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Sang Ok
authors.identifier: 0000-0001-5050-570X
authors.initials: SO
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D001708:Biopterins / Q000031:analogs & derivatives* / Q000032:analysis; D002851:Chromatography, High Pressure Liquid; D002908:Chronic Disease; D054459:Elasticity Imaging Techniques; D005260:Female; D006503:Hepatic Veins / Q000502:physiology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D017082:Portal Pressure; D012044:Regression Analysis; D012720:Severity of Illness Index
chemical_list: D001708:Biopterins; D009569:Nitric Oxide; C003402:sapropterin
keywords: Hypertension, Portal; Liver Cirrhosis; Nitric Oxide