Angiogenesis and Portal Hypertension: An Update
Pp. 162-218 (57)
Dmitry Victorovich Garbuzenko, Nikolay Olegovich Arefyev and Evgeniy Leonidovich Kazachkov
Developing medicines for hemodynamic disorders that are characteristic of
cirrhosis of the liver is a relevant problem in modern hepatology. The increase in
hepatic vascular resistance to portal blood flow and subsequent hyperdynamic
circulation underlie portal hypertension (PH) and promote its progression, despite the
formation of portosystemic collaterals. Angiogenesis and vascular bed restructurization
play an important role in PH pathogenesis as well. In this regard, strategic directions in
the therapy for PH in cirrhosis include selectively decreasing hepatic vascular
resistance while preserving or increasing portal blood flow, and correcting
hyperdynamic circulation and pathological angiogenesis. The aim of this review is to
describe the mechanisms of angiogenesis in PH, methods for studying angiogenesis in
experimental research, and the perspectives of antiangiogenic therapy. Although most
angiogenesis inhibitors were studied only in animal experiments, this selective therapy
for abnormally growing newly formed vessels is pathogenetically reasonable to treat
PH and associated complications.
Angiogenesis, Antiangiogenic Therapy, Liver Cirrhosis, Portal
Hypertension, Pathogenesis, Vascular Remodeling.
South Ural State Medical University, Chelyabinsk, Russia.