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


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2019
Historique:
received: 09 07 2019
accepted: 08 09 2019
entrez: 24 10 2019
pubmed: 24 10 2019
medline: 11 3 2020
Statut: epublish

Résumé

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. 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. 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). Elevated portal venous thromboxane B2 concentrations are possibly associated with the extent of thrombogenic potential in patients with decompensated liver cirrhosis. ClinicalTrials.gov identifier: NCT03584204.

Sections du résumé

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.

Identifiants

pubmed: 31644538
doi: 10.1371/journal.pone.0222840
pii: PONE-D-19-19236
pmc: PMC6808498
doi:

Substances chimiques

Prostaglandins 0

Banques de données

ClinicalTrials.gov
['NCT03584204']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0222840

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Alexander Queck (A)

Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany.

Dominique Thomas (D)

Institute of Clinical Pharmacology, University Hospital Frankfurt, Frankfurt, Germany.

Christian Jansen (C)

Department of Internal Medicine 1, University Hospital Bonn, Bonn, Germany.

Yannick Schreiber (Y)

Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine and Pharmacology (TMP), Frankfurt, Germany.

Sabrina Rüschenbaum (S)

Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany.
Clinic for Gastroenterology and Hepatology, University Hospital Essen and University Duisburg-Essen, Essen, Germany.

Michael Praktiknjo (M)

Department of Internal Medicine 1, University Hospital Bonn, Bonn, Germany.

Katharina Maria Schwarzkopf (KM)

Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany.

Marcus Maximilian Mücke (MM)

Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany.

Robert Schierwagen (R)

Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany.
Department of Internal Medicine 1, University Hospital Bonn, Bonn, Germany.

Frank Erhard Uschner (FE)

Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany.
Department of Internal Medicine 1, University Hospital Bonn, Bonn, Germany.

Carsten Meyer (C)

Department of Radiology, University Hospital Bonn, Bonn, Germany.

Joan Clària (J)

Department of Biochemistry and Molecular Genetics, Hospital Clinic-IDIBAPS and Department of Biomedical Science, University of Barcelona, Barcelona, Spain.
European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain.

Stefan Zeuzem (S)

Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany.

Gerd Geisslinger (G)

Institute of Clinical Pharmacology, University Hospital Frankfurt, Frankfurt, Germany.
Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine and Pharmacology (TMP), Frankfurt, Germany.

Jonel Trebicka (J)

Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany.
Department of Internal Medicine 1, University Hospital Bonn, Bonn, Germany.
European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain.
Institute of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
Institute for Bioengineering of Catalonia, Barcelona, Spain.

Christian Markus Lange (CM)

Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany.
Clinic for Gastroenterology and Hepatology, University Hospital Essen and University Duisburg-Essen, Essen, Germany.

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Classifications MeSH