Endothelial dysfunction in cirrhosis： Role of inflammationand oxidative stress
摘要
This review describes the recent developments in thepathobiology of endothelial dysfunction （ED） in thecontext of cirrhosis with portal hypertension and definesnovel strategies and potential targets for therapy. EDhas prognostic implications by predicting unfavourableearly hepatic events and mortality in patients withportal hypertension and advanced liver diseases. EDcharacterised by an impaired bioactivity of nitric oxide（NO） within the hepatic circulation and is mainly dueto decreased bioavailability of NO and accelerateddegradation of NO with reactive oxygen species.Furthermore, elevated inflammatory markers also inhibitNO synthesis and causes ED in cirrhotic liver. Therefore,improvement of NO availability in the hepatic circulationcan be beneficial for the improvement of endothelialdysfunction and associated portal hypertension inpatients with cirrhosis. Furthermore, therapeutic agentsthat are identified in increasing NO bioavailabilitythrough improvement of hepatic endothelial nitricoxide synthase （eNOS） activity and reduction in hepaticasymmetric dimethylarginine, an endogenous modulatorof eNOS and a key mediator of elevated intrahepaticvascular tone in cirrhosis would be interestingtherapeutic approaches in patients with endothelialdysfunction and portal hypertension in advanced liverdiseases.