title: Portal hypertension as immune mediate disease.
abstract: BACKGROUND
  Portal Hypertension (PH) is a progressive complication due to chronic liver disease. In addition to pathophysiologic changes in the micro-circulation, in PH are established fibrous tissue (periportal fibrous septal) and regenerative hyperplastic nodules (from micro- to macro-nodules) promoting hepatic architectural distortion.
  
  
  METHODS
  A literature search of electronic databases was undertaken for the major studies published from 1981 to today. The databases searched were: PubMed, EMBASE, Orphanet, Midline and Cochrane Library. We used the keywords: "portal hypertension, children, immune system, endocrine system, liver fibrosis".
  
  
  RESULTS
  It is believed that PH results from three "phenotype": ischemia-reperfusion, involving nervous system (NS); edema and oxidative damage, involving immune system; inflammation and angiogenesis, involving endocrine system. However, its exact cause still underdiagnosed and unknown.
  
  
  CONCLUSIONS
  PH is a dynamic and potentially reversible process. Researchers have tried to demonstrate mechanisms underlying PH and its related-complications. This review focuses on the current knowledge regarding the pathogenesis, and immune, endocrine-metabolic factors of disease. The strong positive association between immune system and development of PH could be efficient to identify non-invasive markers of disease, to modify prognosis of PH, and to development and application of specific and individual anti-inflammatory therapy.
authors: Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, University of Messina, Messina, Italy.
authors: Sara
authors: S
authors: Manti
authors: Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, University of Messina, Messina, Italy.
authors: Lucia
authors: L
authors: Marseglia
authors: Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, University of Messina, Messina, Italy.
authors: Gabriella
authors: G
authors: D'Angelo
authors: Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, University of Messina, Messina, Italy.
authors: Martina
authors: M
authors: Filippelli
authors: Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, University of Messina, Messina, Italy.
authors: Caterina
authors: C
authors: Cuppari
authors: Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, University of Messina, Messina, Italy.
authors: Eloisa
authors: E
authors: Gitto
authors: Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, University of Messina, Messina, Italy.
authors: Claudio
authors: C
authors: Romano
authors: Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, University of Messina, Messina, Italy.
authors: Teresa
authors: T
authors: Arrigo
authors: Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, University of Messina, Messina, Italy.
authors: Carmelo
authors: C
authors: Salpietro
keywords: Children; Endocrine System; Immune System; Liver Fibrosis; Portal Hypertension