title: Angiogenesis and portal-systemic collaterals in portal hypertension.
abstract: In patients with advanced liver disease with portal hypertension, portal-systemic collaterals contribute to circulatory disturbance, gastrointestinal hemorrhage, hepatic encephalopathy, ascites, hepatopulmonary syndrome and portopulmonary hypertension. Angiogenesis has a pivotal role in the formation of portal-systemic shunts. Recent research has defined many of the mediators and mechanisms involved in this angiogenic process, linking the central roles of hepatic stellate cells and endothelial cells. Studies of animal models have demonstrated the potential therapeutic impact of drugs to inhibit angiogenesis in cirrhosis. For example, inhibition of VEGF reduces portal pressure, hyperdynamic splanchnic circulation, portosystemic collateralization and liver fibrosis. An improved understanding of the role of other angiogenic factors provides hope for a novel targeted therapy for portal hypertension with a tolerable adverse effect profile.
authors.affiliation: Department of Pediatric Gastroenterology & Nutrition, Division of Pediatrics, Escuela de Medicina, Pontificia Universidad Católica de Chile. Chile.
authors.forename: Juan Cristóbal
authors.initials: JC
authors.lastname: Gana
authors.affiliation: Department of Pediatric Gastroenterology & Nutrition, Division of Pediatrics, Escuela de Medicina, Pontificia Universidad Católica de Chile. Chile.
authors.forename: Carolina A
authors.initials: CA
authors.lastname: Serrano
authors.affiliation: Division of Gastroenterology, Hepatology & Nutrition, Department of Paediatrics, University of Toronto, and The Hospital for Sick Children, Toronto, Canada.
authors.forename: Simon C
authors.initials: SC
authors.lastname: Ling
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D042501:Angiogenic Proteins / Q000378:metabolism; D000818:Animals; D003097:Collateral Circulation / Q000187:drug effects; D004195:Disease Models, Animal; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology*; D008102:Liver Circulation / Q000187:drug effects; D009389:Neovascularization, Pathologic; D011168:Portal System / Q000187:drug effects / Q000503:physiopathology*; D012720:Severity of Illness Index; D015398:Signal Transduction
chemical_list: D020533:Angiogenesis Inhibitors; D042501:Angiogenic Proteins