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Portal hypertension in nonalcoholic fatty liver disease:: Challenges and perspectives

Portal hypertension in nonalcoholic fatty liver disease:: Challenges and perspectives
Portal hypertension in nonalcoholic fatty liver disease:: Challenges and perspectives
Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide. NAFLD-related cirrhosis is often complicated by portal hypertension (PHT). Recent evidence showed that portal venous pressure (PVP) starts to rise in the early stages of NAFLD, even in absence of advanced fibrosis or cirrhosis. However, the precise pathological mechanisms of this process are still poorly understood. Lipid accumulation, hepatocellular ballooning, sinusoidal endothelial cell dysfunction, capillarization, microthrombosis, increased angiogenesis, and pericellular fibrosis may all be involved in the early development of increased PVP in NAFLD. Direct measurement of PHT is invasive and impractical in noncirrhotic NAFLD individuals and may also underestimate its severity. Thus, the development and validation of noninvasive and more accurate measurements, including new serum biomarkers, scoring models, and imaging techniques (such as ultrasonography, elastography, and magnetic resonance imaging), are urgently needed. Owing to the increasing morbidity, challenges in the prevention and management of PHT in NAFLD are unprecedented. This review article aims to briefly discuss these challenges and summarizes the mechanisms, diagnosis, and emerging therapies for PHT in people with NAFLD.
57 - 65
Miao, Lei
6f38f551-c6ee-4a9e-8f50-ab659ef41d40
Targher, Giovanni
54c32fa0-33e3-4774-8a27-d841d044c751
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Valenti, Luca
d25ccf90-03a5-4f62-9352-b6108c705203
Qi, Xiaolong
c084c6ef-f84a-49a6-a79b-8f2cd1721c2c
Zheng, Ming-Hua
6c28fca9-01fb-455b-9272-e9f8853d36e6
Miao, Lei
6f38f551-c6ee-4a9e-8f50-ab659ef41d40
Targher, Giovanni
54c32fa0-33e3-4774-8a27-d841d044c751
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Valenti, Luca
d25ccf90-03a5-4f62-9352-b6108c705203
Qi, Xiaolong
c084c6ef-f84a-49a6-a79b-8f2cd1721c2c
Zheng, Ming-Hua
6c28fca9-01fb-455b-9272-e9f8853d36e6

Miao, Lei, Targher, Giovanni, Byrne, Christopher, Valenti, Luca, Qi, Xiaolong and Zheng, Ming-Hua (2022) Portal hypertension in nonalcoholic fatty liver disease:: Challenges and perspectives. Portal Hypertension & Cirrhosis, 1 (1), 57 - 65. (doi:10.1002/poh2.8).

Record type: Article

Abstract

Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide. NAFLD-related cirrhosis is often complicated by portal hypertension (PHT). Recent evidence showed that portal venous pressure (PVP) starts to rise in the early stages of NAFLD, even in absence of advanced fibrosis or cirrhosis. However, the precise pathological mechanisms of this process are still poorly understood. Lipid accumulation, hepatocellular ballooning, sinusoidal endothelial cell dysfunction, capillarization, microthrombosis, increased angiogenesis, and pericellular fibrosis may all be involved in the early development of increased PVP in NAFLD. Direct measurement of PHT is invasive and impractical in noncirrhotic NAFLD individuals and may also underestimate its severity. Thus, the development and validation of noninvasive and more accurate measurements, including new serum biomarkers, scoring models, and imaging techniques (such as ultrasonography, elastography, and magnetic resonance imaging), are urgently needed. Owing to the increasing morbidity, challenges in the prevention and management of PHT in NAFLD are unprecedented. This review article aims to briefly discuss these challenges and summarizes the mechanisms, diagnosis, and emerging therapies for PHT in people with NAFLD.

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More information

Accepted/In Press date: 21 April 2022
e-pub ahead of print date: 23 June 2022
Published date: 23 June 2022

Identifiers

Local EPrints ID: 467984
URI: http://eprints.soton.ac.uk/id/eprint/467984
PURE UUID: c947558d-9ac7-474a-b201-6ceb666a155f
ORCID for Christopher Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 27 Jul 2022 16:50
Last modified: 17 Mar 2024 07:16

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Contributors

Author: Lei Miao
Author: Giovanni Targher
Author: Luca Valenti
Author: Xiaolong Qi
Author: Ming-Hua Zheng

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