endothelin-1 and Esophageal-and-Gastric-Varices

To investigate variations of plasma endothelin (ET) and its clinical significance in portal hypertensive patients with esophageal variceal hemorrhage.. Sixty-six patients with portal hypertension were randomly divided into 2 groups. Group I (32 patients) received general therapy and Group II (34 patients) received general therapy and UTI after hemorrhage. The plasma ET concentration and liver function were determined at 1, 2, 4, 7, 10, and 14 d after the hemorrhage. Another 20 patients without the hemorrhage were elected as the control group.. At 7 and 14 d after the hemorrhage, the levels of TBIL, ALT and AST were elevated at first and then decreased in Groups I and II. The decrease of TBIL, ALT and AST levels was significantly faster in Group II than in Group I (P < 0.05, P < 0.01, P < 0.05, respectively) on 14 d after the hemorrhage. At 1 d after the hemorrhage the ET concentration was markedly increased in Group I and II as compared with the control group (P < 0.01). Then it was gradually decreased on 10 d after the hemorrhage. The ET concentration in Group II was decreased more rapidly than that in Group I on 2, 4 and 7 d after the hemorrhage (P < 0.05; P < 0.01; P < 0.05, respectively). The ET concentration was positively correlated to TBIL levels in groups I and II (r = 0.734, P < 0.01). And the decreased index of ET concentration was negatively correlated to the increased index of TBIL (r = -0.486, P < 0.05).. The increased plasma ET in portal hypertensive patients with hemorrhage may contribute to liver injury. UTI can protect the liver function by inhibiting ALT, AST, TBIL and ET level.

Topics: Adult; Aged; Endothelin-1; Esophageal and Gastric Varices; Female; Glycoproteins; Humans; Hypertension, Portal; Liver Failure; Male; Middle Aged; Trypsin Inhibitors

The effect of splenomegaly in patients with liver cirrhosis and portal hypertension is not fully understood. This study was designed to determine the effect of laparoscopic splenectomy on portal haemodynamics in these patients.. Patients with liver cirrhosis and portal hypertension who underwent laparoscopic splenectomy in Kyushu University Hospital from January 2006 to March 2009 were evaluated retrospectively. Correlations between splenic size and portal haemodynamics, and changes in portal haemodynamics and in levels of the vasoactive agents endothelin (ET) 1 and nitric oxide metabolites (NOx) before and 7-10 days after laparoscopic splenectomy were analysed.. Portal venous (PV) blood flow, PV cross-sectional area and PV congestion index correlated significantly with splenic size (P < 0·050). All three were significantly reduced following splenectomy in 59 patients. The hepatic venous pressure gradient, measured in 18 patients, decreased by 25 per cent after splenectomy (P < 0·001). Portal vascular resistance was also reduced, by 21 per cent (P = 0·009). The peripheral blood concentration of ET-1 decreased from 2·95 to 2·11 pg/ml (P < 0·001), and that of NOx tended to decrease (from 29·2 to 25·0 pg/ml; P = 0·068). In hepatic venous blood, the level of ET-1 decreased from 2·37 to 1·83 pg/ml (P = 0·006), whereas NOx concentration tended to increase (from 24·5 to 30·9 pg/ml; P = 0·067).. In patients with liver cirrhosis and portal hypertension, splenectomy reduced portal venous pressure. A decrease in splanchnic blood flow, by eliminating splenic blood flow, and reduction in intrahepatic vascular resistance, by normalizing hepatic concentrations of ET-1 and NOx, may both have contributed.

Topics: Ascites; Blood Cell Count; Blood Flow Velocity; Endothelin-1; Esophageal and Gastric Varices; Hemodynamics; Humans; Hypertension, Portal; Laparoscopy; Liver Cirrhosis; Male; Middle Aged; Nitric Oxide; Organ Size; Prothrombin Time; Retrospective Studies; Splanchnic Circulation; Spleen; Splenectomy; Treatment Outcome

The aims of this study were to determine 1. the variation of blood TGF beta 1 and ET-1 in patients with liver cirrhosis; 2. the relationship of the blood TGF beta 1 and ET-1 with Child degree of liver function and the severity of esophageal varices.. Peripheral blood samples were obtained from 72 patients and 24 normal controls. The blood levels of TGF beta 1 and ET-1 were measured by using a standard bioassay and the radioimmunoassay.. TGF beta 1 level (11.77 +/- 1.32 ng/ml) and ET-1 level (78.37 +/- 17.54 pg/ml) were significantly higher in the patients than those in controls(P < 0.05). The increase of the ET-1 in the patients is closely associated with Child degree of liver function (r = 0.94) and the severity of esophageal varices(r = 0.87). TGF beta 1 concentration is not associated with Child degree of liver function (r = 0.11) and the severity of esophageal varices (r = 0.03).. TGF beta 1 and ET-1 may play an important role in the pathophysiologic process of cirrhosis. ET-1 concentration may reflect portal hypertension development.

Topics: Adult; Aged; Biomarkers; Endothelin-1; Esophageal and Gastric Varices; Female; Humans; Liver Cirrhosis; Male; Middle Aged; Prognosis; Transforming Growth Factor beta; Transforming Growth Factor beta1

To investigate the level of plasma calcitonin gene related peptide (CGRP) and endothelin-1 (ET-1) to assess their role on portal hypertension formation and progression and liver function injury in liver cirrhosis and the possible relation between them.. CGRP and ET-1 were measured in plasma samples collected from 24 healthy controls and 61 liver cirrhosis patients.. Plasma CGRP and ET-1 level were significantly higher in cirrhotic patients than those in healthy controls. Comparisons of the levels of plasma CGRP and ET-1 in group of patients with different liver function were shown as follows: Child C > Child B > Child A. An analysis among the groups showed that plasma CGRP and ET-1 were markedly higher in the groups with esophageal varices accompanied by severe or moderate ascites (LC(4)) and with simple severe or moderate ascites (LC(3)) than in the groups with esophageal varices accompanied by mild or no ascites (LC(2)). The levels were also significantly higher in group LC(2) than those in group without varices and ascites (LC(1)). No statistical difference of plasma CGRP and ET-1 levels was found between group LC(1) or Child A and normal controls. There was positive correlation between plasma CGRP and ET-1. The increased concentration of both of them correlated negatively with the declined level of plasma albumin.. The increase of plasma CGRP and ET-1 is closely associated with the severity of liver cirrhosis and the formation and progression of portal hypertension. The disturbance of the balance between plasma CGRP and ET-1 may contribute to the pathologic process of liver injury.

Topics: Adult; Ascites; Calcitonin Gene-Related Peptide; Endothelin-1; Esophageal and Gastric Varices; Female; Humans; Hypertension, Portal; Liver Cirrhosis; Male; Middle Aged; Radioimmunoassay