Pathophysiological role of prostanoids in coagulation of the portal venous system in liver cirrhosis


Autoři: Alexander Queck aff001;  Dominique Thomas aff002;  Christian Jansen aff003;  Yannick Schreiber aff004;  Sabrina Rüschenbaum aff001;  Michael Praktiknjo aff003;  Katharina Maria Schwarzkopf aff001;  Marcus Maximilian Mücke aff001;  Robert Schierwagen aff001;  Frank Erhard Uschner aff001;  Carsten Meyer aff006;  Joan Clària aff007;  Stefan Zeuzem aff001;  Gerd Geisslinger aff002;  Jonel Trebicka aff001;  Christian Markus Lange aff001
Působiště autorů: Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany aff001;  Institute of Clinical Pharmacology, University Hospital Frankfurt, Frankfurt, Germany aff002;  Department of Internal Medicine 1, University Hospital Bonn, Bonn, Germany aff003;  Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine and Pharmacology (TMP), Frankfurt, Germany aff004;  Clinic for Gastroenterology and Hepatology, University Hospital Essen and University Duisburg-Essen, Essen, Germany aff005;  Department of Radiology, University Hospital Bonn, Bonn, Germany aff006;  Department of Biochemistry and Molecular Genetics, Hospital Clinic-IDIBAPS and Department of Biomedical Science, University of Barcelona, Barcelona, Spain aff007;  European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain aff008;  Institute of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark aff009;  Institute for Bioengineering of Catalonia, Barcelona, Spain aff010
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222840

Souhrn

Background

Prostanoids are important regulators of platelet aggregation and thrombotic arterial diseases. Their involvement in the development of portal vein thrombosis, frequent in decompensated liver cirrhosis, is still not investigated.

Methods

Therefore, we used pro-thrombotic venous milieu generation by bare metal stent transjugular intrahepatic portosystemic shunt insertion, to study the role of prostanoids in decompensated liver cirrhosis. Here, 89 patients receiving transjugular intrahepatic portosystemic shunt insertion were included in the study, and baseline levels of thromboxane B2, prostaglandin D2 and prostaglandin E2 were measured in the portal and the hepatic vein.

Results

While the hepatic vein contained higher levels of thromboxane B2 than the portal vein, levels of prostaglandin E2 and D2 were higher in the portal vein (all P<0.0001). Baseline concentrations of thromboxane B2 in the portal vein were independently associated with an increase of portal hepatic venous pressure gradient during short term follow-up, as an indirect sign of thrombogenic potential (multivariable P = 0.004). Moreover, severity of liver disease was inversely correlated with portal as well as hepatic vein levels of prostaglandin D2 and E2 (all P<0.0001).

Conclusions

Elevated portal venous thromboxane B2 concentrations are possibly associated with the extent of thrombogenic potential in patients with decompensated liver cirrhosis.

Trial registration

ClinicalTrials.gov identifier: NCT03584204.

Klíčová slova:

Cirrhosis – Liver diseases – Platelets – Thrombosis – Veins – Portal veins – Prostaglandin – Thromboxane


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2019 Číslo 10