Navigation Links
New advances in the management of patients with cirrhosis

Amsterdam, The Netherlands, Thursday 25 April 2013: New data from clinical studies presented for the first time at the International Liver Congress 2013 provide new rationale for an old and established treatment option for portal hypertension. Additionally, spleen stiffness predicts the occurrence of clinical complications, which is of paramount importance in clinical practice.

In patients with cirrhosis, increasing blood pressure in the abdominal circulatory system (known as portal hypertension) leads to potentially lethal complications which might be prevented with simple medical treatment. Patients with cirrhosis and portal hypertension have increased gastrointestinal permeability which allows the movement of bacteria or bacterial components through the lining of the gut into the blood stream in a process known as bacterial translocation. Bacterial components such as lipopolysaccharide can be involved in the genesis of complications of cirrhosis.

The first study evaluated the effects of a non-selective beta-blocker (NSBB) on gastrointestinal permeability and bacterial translocation in patients with cirrhosis with high levels of portal hypertension.1 Patients with severe portal hypertension (HVPG* ≥20mmHg) had increased markers of gastrointestinal permeability and bacterial translocation compared to patients with lower levels of portal hypertension (HVPG<20mmHg). Treatment with NSBB significantly reduced HVPG, improved gastrointestinal permeability and decreased bacterial translocation (LPS-binding protein (LBP) -16% p=0.018; IL-6 -41% p< 0.0001) levels.

Patients who were found to have the highest levels of gastrointestinal permeability were also found to be at most risk of bleeding from oesophageal varices; a complication of cirrhosis which carries a high risk of mortality.

These findings provide a new rationale for the use of non-selective beta-blockers in patients with cirrhosis. EASL's Treasurer Prof. Mauro Bernardi commented on the data: "The movement of bacteria from the gut and into the bloodstream is extremely serious and potentially fatal in patients with cirrhosis often leading to complications or death. Beta-blockers have been successfully used in a number of conditions and as a standard treatment to control blood pressure in other disease areas. In cirrhosis, they have been used for decades for primary and secondary prophylaxis of bleeding from oesophageal varices. The results of this study show that besides improving portal hypertension, as it was thought up to now, their beneficial effects are also due to their ability to reduce bacterial translocation which may widen the indications for the use of these drugs in this setting."

In the diagnostic landscape, promising data to support the validity of non-invasive techniques were also presented at the congress. HVPG, an invasive measurement technique currently considered as the best predictor to identify progression to severe scarring of the liver and disrupted essential body functions (clinical decompensation), was compared to techniques such as the evaluation of spleen stiffness (SS) combined with the MELD** score.2  

The study showed that in compensated (early) patients with cirrhosis both the SS (p<0.0001) and the MELD (p=0.016) score provided an accurate prediction of clinical decompensation, and their combination in a new score had a predicting power even superior to that of HVPG.

Prof. Mauro Bernardi added, "HVPG is an invasive technique, which can often be discomforting for patients, is only performed in specialised centres and needs experienced operators to be fully reliable. While further studies will be required, if non-invasive techniques continue to present accurate predictions, they would be welcomed in the overall management of compensated patients with cirrhosis."

Disclaimer: the data referenced in this release is based on the submitted abstract. More recent data may be presented at the International Liver Congress 2013.


Contact: Dimple Natali
European Association for the Study of the Liver

Related biology news :

1. Advances in personalized medicine for lung cancer
2. 5th Annual Advances in Biomolecular Engineering Symposium
3. March of Dimes awards $250,000 prize to 2 scientists who pioneered advances in skin disorders
4. University of North Texas Health Science Center Advances Forensic Research by Investing in Semiconductor DNA Sequencing Technology
5. Computing advances vital to sustainability efforts; new report recommends problem-focused, iterative approach to research
6. Major advances in understanding the regulation and organization of the human genome
7. Geologist calls for advances in restoration sedimentology
8. Study advances use of stem cells in personalized medicine
9. Discovery of 100 million-year-old regions of DNA shows short cut to crop science advances
10. IOF Asia-Pacific Meeting presents new research and advances in osteoporosis management
11. Discovery of first motor with revolution motion in a virus-killing bacteria advances nanotechnology
Post Your Comments:
(Date:6/22/2016)... 22, 2016   Acuant , the ... solutions, has partnered with RightCrowd ® ... Visitor Management, Self-Service Kiosks and Continuous Workforce ... add functional enhancements to existing physical access ... venues with an automated ID verification and ...
(Date:6/21/2016)... 21, 2016 NuData Security announced today that ... of principal product architect and that Jon ... customer development. Both will report directly to ... moves reflect NuData,s strategic growth in its product ... customer demand and customer focus values. ...
(Date:6/16/2016)... SAN FRANCISCO , June 16, 2016 /PRNewswire/ ... Market size is expected to reach USD ... report by Grand View Research, Inc. Technological proliferation ... and banking applications are expected to drive the ... ) , The development of ...
Breaking Biology News(10 mins):
(Date:6/27/2016)... /PRNewswire/ - BIOREM Inc. (TSX-V: BRM) ("Biorem" or "the Company") ... shareholders, Clean Technology Fund I, LP and Clean Technology ... based venture capital funds which together hold approximately 59% ... diluted, as converted basis), that they have entered into ... holdings in Biorem to TUS Holdings Co. Ltd. ("TUS") ...
(Date:6/27/2016)... Raleigh, NC (PRWEB) , ... June 27, 2016 ... ... have just published their findings on what they believe could be a new ... summary of the new research. Click here to read it now. ...
(Date:6/27/2016)... NC (PRWEB) , ... June 27, 2016 , ... ... mission to bring innovative medical technologies, services and solutions to the healthcare market. ... and implementation of various distribution, manufacturing, sales and marketing strategies that are necessary ...
(Date:6/27/2016)...  Liquid Biotech USA , ... Sponsored Research Agreement with The University of Pennsylvania ... cancer patients.  The funding will be used to ... clinical outcomes in cancer patients undergoing a variety ... employed to support the design of a therapeutic, ...
Breaking Biology Technology: