Advances in intrahepatic and extrahepatic vascular dysregulations in cirrhotic portal hypertension
Cirrhotic portal hypertension, the most prevalent and clinically significant complication of liver cirrhosis, manifests as elevated portal venous pressure and is associated with severe complications. Although much research on the mechanisms of portal hypertension has focused on liver fibrosis, less...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1515400/full |
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| author | Yanqiu Li Bingbing Zhu Ke Shi Yu Lu Xuanwei Zeng Yongqi Li Qun Zhang Ying Feng Xianbo Wang |
| author_facet | Yanqiu Li Bingbing Zhu Ke Shi Yu Lu Xuanwei Zeng Yongqi Li Qun Zhang Ying Feng Xianbo Wang |
| author_sort | Yanqiu Li |
| collection | DOAJ |
| description | Cirrhotic portal hypertension, the most prevalent and clinically significant complication of liver cirrhosis, manifests as elevated portal venous pressure and is associated with severe complications. Although much research on the mechanisms of portal hypertension has focused on liver fibrosis, less attention has been given to the role of intrahepatic and extrahepatic vascular dysfunction, particularly with respect to extrahepatic vasculature. While the role of hepatic fibrosis in cirrhotic portal hypertension is undeniable, the underlying mechanisms involving intrahepatic and extrahepatic vasculature are highly complex. Sinusoidal capillarization and endothelial dysfunction contribute to increased intrahepatic vascular resistance. Hemodynamic changes in the extrahepatic circulation, including splanchnic vasodilation and hyperdynamic circulation, play a significant role in the development of portal hypertension. Additionally, therapeutic strategies targeting these vascular mechanisms are diverse, including improvement of sinusoidal microcirculation, therapies targeting hepatic stellate cells activation, and pharmacological modulation of systemic vascular tone. Therefore, in this review, we will discuss the vascular-related mechanisms and treatment progress of portal hypertension in cirrhosis to provide a new theoretical basis and practical guidance for clinical treatment. |
| format | Article |
| id | doaj-art-fe544c7081c9432f858bcf84412282db |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj-art-fe544c7081c9432f858bcf84412282db2025-01-31T06:40:18ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011210.3389/fmed.2025.15154001515400Advances in intrahepatic and extrahepatic vascular dysregulations in cirrhotic portal hypertensionYanqiu LiBingbing ZhuKe ShiYu LuXuanwei ZengYongqi LiQun ZhangYing FengXianbo WangCirrhotic portal hypertension, the most prevalent and clinically significant complication of liver cirrhosis, manifests as elevated portal venous pressure and is associated with severe complications. Although much research on the mechanisms of portal hypertension has focused on liver fibrosis, less attention has been given to the role of intrahepatic and extrahepatic vascular dysfunction, particularly with respect to extrahepatic vasculature. While the role of hepatic fibrosis in cirrhotic portal hypertension is undeniable, the underlying mechanisms involving intrahepatic and extrahepatic vasculature are highly complex. Sinusoidal capillarization and endothelial dysfunction contribute to increased intrahepatic vascular resistance. Hemodynamic changes in the extrahepatic circulation, including splanchnic vasodilation and hyperdynamic circulation, play a significant role in the development of portal hypertension. Additionally, therapeutic strategies targeting these vascular mechanisms are diverse, including improvement of sinusoidal microcirculation, therapies targeting hepatic stellate cells activation, and pharmacological modulation of systemic vascular tone. Therefore, in this review, we will discuss the vascular-related mechanisms and treatment progress of portal hypertension in cirrhosis to provide a new theoretical basis and practical guidance for clinical treatment.https://www.frontiersin.org/articles/10.3389/fmed.2025.1515400/fullcirrhotic portal hypertensionsinusoidal capillarizationendothelial dysfunctionsplanchnic vasodilationhyperdynamic circulationnitric oxide |
| spellingShingle | Yanqiu Li Bingbing Zhu Ke Shi Yu Lu Xuanwei Zeng Yongqi Li Qun Zhang Ying Feng Xianbo Wang Advances in intrahepatic and extrahepatic vascular dysregulations in cirrhotic portal hypertension Frontiers in Medicine cirrhotic portal hypertension sinusoidal capillarization endothelial dysfunction splanchnic vasodilation hyperdynamic circulation nitric oxide |
| title | Advances in intrahepatic and extrahepatic vascular dysregulations in cirrhotic portal hypertension |
| title_full | Advances in intrahepatic and extrahepatic vascular dysregulations in cirrhotic portal hypertension |
| title_fullStr | Advances in intrahepatic and extrahepatic vascular dysregulations in cirrhotic portal hypertension |
| title_full_unstemmed | Advances in intrahepatic and extrahepatic vascular dysregulations in cirrhotic portal hypertension |
| title_short | Advances in intrahepatic and extrahepatic vascular dysregulations in cirrhotic portal hypertension |
| title_sort | advances in intrahepatic and extrahepatic vascular dysregulations in cirrhotic portal hypertension |
| topic | cirrhotic portal hypertension sinusoidal capillarization endothelial dysfunction splanchnic vasodilation hyperdynamic circulation nitric oxide |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1515400/full |
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