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616.149-008.341.1-08 (1) |
Патология сердечно-сосудистой системы. Сердечно-сосудистые заболевания (975) |
SM ISO690:2012 TCACIUC, Eugen. Perspective în tratamentul hipertensiunii portale. In: Sănătate Publică, Economie şi Management în Medicină , 2016, nr. 1(65), pp. 63-71. ISSN 1729-8687. |
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Sănătate Publică, Economie şi Management în Medicină | ||||||
Numărul 1(65) / 2016 / ISSN 1729-8687 /ISSNe 2587-3873 | ||||||
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CZU: 616.149-008.341.1-08 | ||||||
Pag. 63-71 | ||||||
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Portal hypertension is associated with the most severe complications of cirrhosis, including ascites, hepatic encephalopathy, and bleeding from gastro-esophageal varices. In patients with chronic liver disease, portal hypertension is driven by progressive fibrosis and intrahepatic vasoconstriction. Chronic liver lesions caused by infections, toxins, cholestasis, metabolic or autoimmune diseases induce a cascade of inflammatory processes that lead to activation of hepatic stellate cells to hepatic myofibroblasts, the key cells in the process of fi brogenesis. These cells also have contractile properties; they proliferate and are involved in a complex crosstalk with immune cells. When activated, they express receptors which lead to an enhanced response to transforming growth factor-beta, platelet-derived growth factor, angiotensin II, or chemokines. These phenomena together with extracellular matrix proteins and integrins are involved in the modulation of the profibrotic activity of the myofibroblasts. Interrupting the mechanisms underlying the initiation and perpetuation of portal hypertension in chronic liver diseases is the ideal approach to counteract the complications associated with portal hypertension. If chronic liver injury supporting fi brogenesis and portal hypertension cannot be interrupted, a wide variety of tools are available to modulate and reduce intrahepatic resistance and therewith portal hypertension. Also, some wellestablished drugs, which are used in humans for other indications (for example, statins or angiotensin II type I receptor blockers), are promising if applied early and concomitantly to standard therapy. A better understanding of the process of regression of cirrhotic process could be a key to developing future methods to treat portal hypertension |
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Cuvinte-cheie portal hypertension, liver fibrosis, liver cirrhosis, treatment |
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