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Who is the arch-criminal in the development of hepatopulmonary syndrome?
Date:12/19/2007

The hepatopulmonary syndrome (HPS) develops when an arterial oxygenation deficiency occurs due to intra-pulmonary vascular dilatations that are often associated with severe hepatic disease. HPS occurs in 15-20% of patients with liver cirrhosis undergoing evaluation for orthotopic liver transplantation. Recent studies support that the presence of HPS significantly increases mortality in cirrhosis, particularly in those with decompensated liver disease.

One of the characteristics of HPS is intra-pulmonary vascular dilatation. The intra-pulmonary vascular dilatation severely affects pulmonary gas exchange, and consequently leads to hypoxia and raised mortality of cirrhotic patients. The present research hotspots focus mainly on clarifying the pathogenesis of HPS, particularly in exploring the mechanism of intra-pulmonary vascular dilatation.

Dr. Hui-Ying Zhang et al. developed a rat model characteristic of cirrhosis and HPS that can be non-invasively induced by multiple pathogenic factors including high fat diet, alcohol, cholesterol, corn flour and CCl4 and demonstrated a significantly increased level of lipopolysaccharide (LPS) in plasma is closely related to the decreased blood oxygen content and intra-pulmonary vascular dilatation. And they further characterized the relation between the progeression and severity of HPS and the degree of hepatic dysfunction, and explored how intestinal endotoxemia (IETM) affects the intra-pulmonary vascular dilatation.

In the research, Dr. Zhang et al. dynamically observed typical histological changes in both liver and lung and found that the progression and severity of HPS were closely associated with increased plasma LPS level, and that there was a paralleling deterioration between the lung function and the hepatic function in the cirrhotic rats. This indicated that HPS is interrelated with underlying liver disease and supported their hypothesis that hepatic pathological alteration is a substantia
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Contact: Jing Zhu
j.zhu@wjgnet.com
World Journal of Gastroenterology
Source:Eurekalert

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