Pathophysiological-based treatments of complications of cirrhosis

Abstract

Detailed knowledge and understanding of the pathophysiological mechanisms and changes in hepatic and splanchnic function leading to the development of haemodynamic changes and portal hypertension in patients with cirrhosis are essential since it guides the search for targets to ameliorate liver-related abnormalities. Recent research has focused on the gut-liver axis, changes in intestinal permeability, translocation of bacterial products, and inflammation as important drivers of haemodynamic alterations and thereby targets for treatment. Additionally, treatment strategies should focus on microbiotic modulation, antiangiogenics, anti-inflammatory strategies, and modulation of bile acid metabolism. This paper aims to review contemporary pathophysiological-based treatment principles of the major complications of cirrhosis and portal hypertension and future targets for treatment.

Keywords:

• Portal hypertension
• ascites
• oesophageal varices
• hyperdynamic circulation
• hepatorenal syndrome
• hepatopulmonary syndrome

Disclosure statement

None of the authors had any conflicts of interest.

Additional information

Funding

Professor Søren Møller was supported by grants from the Novo Nordisk Foundation, The Capital Region of Copenhagen, and The University of Copenhagen.