Author/Authors :
Manti, Sara University of Messina - Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, Italy , Marseglia, Lucia University of Messina - Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, Italy , Angelo, Gabriella D University of Messina - Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, Italy , Filippelli, Martina University of Messina - Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, Italy , Cuppari, Caterina University of Messina - Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, Italy , Gitto, Eloisa University of Messina - Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, Italy , Romano, Claudio University of Messina - Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, Italy , Arrigo, Teresa University of Messina - Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, Italy , Salpietro, Carmelo University of Messina - Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, Italy
Abstract :
Context: Portal Hypertension (PH) is a progressive complication due to chronic liver disease. In addition to pathophysiologic changes in the micro-circulation, in PH are established fibrous tissue (periportal fibrous septal) and regenerative hyperplastic nodules (from micro- to macro-nodules) promoting hepatic architectural distortion. Evidence Acquisition: A literature search of electronic databases was undertaken for the major studies published from 1981 to today. The databases searched were: PubMed, EMBASE, Orphanet, Midline and Cochrane Library. We used the keywords: portal hypertension, children, immune system, endocrine system, liver fibrosis. Results: It is believed that PH results from three “phenotype”: ischemia-reperfusion, involving nervous system (NS); edema and oxidative damage, involving immune system; inflammation and angiogenesis, involving endocrine system. However, its exact cause still underdiagnosed and unknown. Conclusions: PH is a dynamic and potentially reversible process. Researchers have tried to demonstrate mechanisms underlying PH and its related-complications. This review focuses on the current knowledge regarding the pathogenesis, and immune, endocrine-metabolic factors of disease. The strong positive association between immune system and development of PH could be efficient to identify non-invasive markers of disease, to modify prognosis of PH, and to development and application of specific and individual anti-inflammatory therapy.
Keywords :
Portal Hypertension , Children , Immune System , Endocrine System , Liver Fibrosis
