Endothelial Dysfunction and Systemic Inflammation in the Pathogenesis and Progression of Portal Hypertension

Hepatic and extrahepatic factors contribute to mortality related to liver cirrhosis and therefore much research is still to be done in order to understand the condition thoroughly and to possibly intervene in the process. It is considered that the currently applied prognostic scores are not ideal mortality predictors. On the other hand, recent scientific concepts have revealed the significant contributing role of endothelial dysfunction and of systemic inflammation in the pathogenesis of portal hypertension. Consequently, these concepts are inevitably leading towards proposing and validating new prognostic indicators in cirrhotic patients. Von-Willebrand factor as an indicator of endothelial dysfunction and C-reactive protein as a surrogate marker of systemic inflammation and several other parameters and biological markers have been emerging as a relevant and potentially useful prognostic indicators. Also, the coagulopathy associated to liver disease is in close relation with these entities and still an important research topic. Despite the promising data regarding their prognostic potential, additional research is needed in order to define and validate their value more precisely in clinical and prognostic settings.