P.O.Box 2345 Beijing 100023, China
Fax. 0086· 10· 65891893 Tel. 0086· 10· 65897901
E-mail.wcjd public.bta.net.cn
www.wd.org.cn
World J Gastroentero, 2001; 7(1):126 - 127
World Journal of Gastroenterology
Copyright  2001 by the WJG Press ISSN 1007 - 9327
Plasma endothelin in patients with endotoxemia
and dynamic comparison between vasoconstrictor
and vasodilator in cirrhotic patients
Feng Liu1, Ji Xin Li2, Chun Mei Li2 and Xi Sheng Leng2
Subject headings hypertension, portal; liver cirrhosis;
portosystemic shunt, surgical; endothelins;
radioimmunoassay; epoprostenol; liver cirrhosis
Liu F, Li JX, Li CM, Leng XS. Plasma endothelin in patients with
endotoxemia and dynamic comparison between vasoconstrictor and
vasodilator in cirrhotic patients. World J Gastroenterol, 2001;7(1):
126-127
INTRODUCTION
Portal hypertension is a common clinical syndrome
characterized by an abnormal increase in portal blood to
the systemic circulation, bypassing the liver. Recent
studies have reported that humoral substances play an
important role in the pathogenesis of portal hypertension,
either by increasing vascular resistance at both the
intrahepatic and porto-collateral sites or affecting
splanchnic vasodilation with a concomitant increase in
parto-collateral blood flow[1-6].
Endothelin (ET) released by endothelial cells is a
21-amino acid peptide with potent vasoconstrictor
action. Endothelin comprises a family of four
homologous isopeptides in human and animals (ET-1,
ET-2, and ET-3, VIC)[7-14]. Most reported data are
related to ET-1, which is the most powerful
vasoconstrictor. Owing to a variety of reasons, reports
concerning endothelin levels in cirrhotics are not
consistent with each other. Endothelin concentrations
in plasma have been reported to be increased in some
studies and normal or reduced in others[15-20]. Present
evidence suggests that endothelin may play an
important role in modulating intrahepatic vascular
resistance[21-24]. However, the relationship between
vasoconstrictor (ET, TX-) and vasodilator (PGI2) during
portosystemic shunt has not been documented.
1
Department of General Surgery, the Fifth Affiliated Hospital, Harbin
Medical University, Harbin 150036, Heilongjiang Province, China
2
Department of General Surgery, People’s Hospital, Medical University,
Beijing 100044, China
Dr. Feng Liu, graduated from Beijing Medical University as a
postgraduate in 1995, now associate professor of general surgery,
majoring hepatobilliary surgery, having 12 papers published.
Project supported by the National Natural Science Foundation
and Ministry of Public Health of China, No.37600481
Correspondence to: Dr. Feng Liu, Department of General Surgery,
the Fifth Affiliated Hospital, Harbin Medical University, Harbin 150036,
Heilongjiang Province, China
Tel. 0086-51-5314098, Fax. 0098-51-5314088
Email.lfdlyy.163.net.
Received 2000-07-26 Accepted 2000-09-29
METHODS
We measured the concentration of endothelin in plasma
using radioimmunoassay in 121 patients with cirrhosis
and compared these values with 50 age- and sex-matched
control subjects, and evaluated systemic endotoxemia.
At the same time, perioperative plasma vasoconstrictor
and vasodilator were clinically observed in 30
portohypertensive cirrhotic patients undergoing
portosystemic shunt.
RESULTS
Plasma endothelin levels were higher in cirrhotic patients
with ascites than in those without ascites. Femoral venous
plasma endothelin levels averaged 90 ± 23 ng/L in
cirrhotic patients versus 34 ± 8 ng/L in controls (P = 0.
000), and that of cirrhotics with ascites was higher than
those without 106 ± 17 ng/L vs 90 ± 23 ng/L(P = 0.002).
Moreover, plasma endothelin levels increased in
proportion to the severity of endotoxemia (rs = 0.61, P =
0.034). Both the levels of plasma vasoconstrictors (ET,
TX-) and of the vasodilator (PGI2) were higher in
portohypertensive cirrhotic patients (ET: 107.8 ± 25.9
ng/Lvs 48.1 ± 9.4 (P = 0.000); TX-: 349.7 ± 198.4 ng/L
vs 156.3 ± 54 (P = 0.000); PGI2: 463.1 ± 108.3 ng/L vs
227.2 ± 46 (P = 0.000), and their concentrations
decreased significantly in patients after portosystemic
shunt (P = 0.002).
DISCUSSION
These results suggest that endothelin has significant
influence on the portal vascular resistance of cirrhotic
liver in vivo and may play an important role in the
pathogenesis of portal hypertension[25-28]. Endotoxin may
lead to the increased synthesis and release of endothelin.
It could be that a dynamic balance between levels of
vasoconstrictor and vasodilator in plasma exists in the
pathophysiology of portohypertensive cirrhotic patients
after portosystemic shunt.
REFERENCES
1
2
3
Boyer TD. Portal hypertensive hemorrhage: pathogenesis and
risk factors. Seminars Gastrointest Dis, 1995;6:125-133
Zhang ZY, Ren XL, Yao XX. Alterations and relationship of
plasma endotoxin and nitric oxide in patients with cirrhosis. Xin
Xiaohuabingxue Zazhi, 1997;5:369-370
Yu Y, Tian HM, Shi ZG, Yao YM, Wang YP, Lu LR, Yu Y, Chang
GY, Ma NS, Sheng ZY. Relationship between endotoxemia
and dysfunction of intestinal immunoa-barrier after scald in rats.
Liu F. Vasoconstrictor and vasodilator in cirrhotic patients
4
5
6
7
8
9
10
11
12
13
14
15
16
Huaren Xiaohua Zazhi, 1998;6:703-704
Chen S, Liu B, Cai XM, Gu CH. Clinical significance of changes of
endothelin and nitric oxide levels in peripheral blood of patients
with severe hepatitis. Shijie Huaren Xiaohua Zazhi, 1999;7:122124
Assy N, Paizi M, Gaitini D, Baruch Y, Spira G. Clinical implication of VEGF serum levels in cirrhotic patients with or without
portal hypertension. World J Gastroentero, 1999;5:296-300
Huang YQ, Xiao SD, Zhang DZ, Mo JZ. Nitric oxide synthase
distribution in esophageal mucosa and hemodynamic changes in
rats with cirrhosis. World J Gastroentero, 1999;5:213-216
Wang JY, Wang XL, Liu P. Detection of serum TNF-α, IFN-γ, IL26 and IL-28 in patients with hepatitis B. World J Gastroentero,
1999;5:38-40
Xu KD, Liu TF, Cing X. Significance of detection of plasma nitric
oxide, endothelin, endotoxin in patients with liver cirrhosis. World
J Gastroenterol, 1998;4(Suppl 2):64
Liu ZH. Clinical study of therapeutic effect of dong fang gan kang
no.1 on fatty liver. World J Gastroenterol, 1998;4(Suppl 2):73
Xu YJ, Liu XN, Guan HW, Zhu LH, Bai DS. Diagnosis and treatment of spontaneous rupture of liver carcinoma with bleeding.
World J Gastroentero, 1998;4(Suppl 2):81
Wu MC. Clinical research advances in primary liver cancer. World
J Gastroentero, 1998;4:471-474
Yao XX, Cui DL, Sui YF, Li XT. Clinical and experimental study
of effect of Raondix Salviae Militiorrhiza and other blood-activating and stasisa-eliminating Chinese herbs on hemodynamics of
portal hypertension. World J Gastroentero, 1998;4:439-442
Yu YY, Si CW, Tian XL, He Q, Xue HP. Effect of cytokines on
liver necrosis. World J Gastroenterol, 1998;4:311-313
Jia JB, Han DW, Xu RL, Gao F, Zhao LF, Zhao YC, Yan JP, Ma
XH. Effect of endotoxin on fibronectin synthesis of rat primary
cultured hepatocytes. World J Gastroenterol, 1998;4:329-331
Yang JM, Han DW, Xie CM, Liang QC, Zhao YC, Ma XH. Endotoxins enhance hepatocarcinogenesis induced by oral intake of
thioacetamide in rats. World J Gastroentero, 1998;4:128-132
Liu GS, Huang YX, Li SW, Pan BR, Wang X, Sun DY, Wang QL.
Experimental study on mechanism and protection of stress ulcer
produced by explosive noise. World J Gastroenterol, 1998;4:519-
127
17
18
19
20
21
22
23
24
25
26
27
28
523
Lu MD, Yin YY, Ren W. A study of portal vein embolization with
absolute ethanol injection in cirrhotic rats. World J Gastroenterol,
1998;4:415-417
Assy N, Gong YW, Zhang M, Minuk GY. Appearance of an inhibitory cell nuclear antigen in rat and human serum during variable
degrees of hepatic regenerative activity. World J Gastroenterol,
1999;5:103-106
Assy N, Minuk GY. A comparison between previous and present
histologic assessments of chronic hepatitis C viral infections in
humans. World J Gastroentero, 1999;5:107-110
He P, Tang ZY, Ye SL, Liu BB. Relationship between expression of
fetoprotein messenger RNA and some clinical parameters of human
hepatocellular carcinoma. World J Gastroenterol, 1999;5:111-115
Peng XM, Yao CL, Chen XJ, Peng WW, Gao ZL. Codon 249
mutations of p53 gene in non-neoplastic liver tissues. World J
Gastroenterol, 1999;5:324-326
Saitoh O, Sugi K, Kojima K, Matsumoto H, Nakagawa K, Kayazawa
M, Tanaka S, Teranishi T, Hirata I, Katsu KI. Increased prevalence of intestinal inflammation in patients with liver cirrhosis.
World J Gastroenterol, 1999;5:391-396
Li ZZ, Wei CD, Wang Y, Xing C, Guo H, Cai W, Liu H. The effect
of cold upon upper gastrointestinal hemorrhage resulting from
liver cirhosis and its mechanism. World J Gastroenterol, 1998;4
(Suppl 2):74
Pan RM, Shao XD. Clinical characteristics of alcoholic liver disease.
World J Gastroenterol, 1998;4(Suppl 2):95-96
We i H , Wa n g Y X . A c l i n i c a l a n a l y s i s o f 3 6 c a s e s o f
hepatopulmonary syndrome. World J Gastroenterol, 1998;4(Suppl
2):101
Gu SQ, Li LY, Li Z, He D. Analysis on clinical features of hepatic
encephalopathy of 108 cases. World J Gastroenterol, 1998;4(Suppl
2):101
Wu CH. Fibrodynamics-aelucidation of the mechanisms and sites
of liver fibrogenesis. World J Gastroenterol, 1999;5:388-390
Cheng ML, Wu YY, Huang KF, Luo TY, Ding YS, Lu YY, Liu RC,
Wu J. Clinical study on the treatment of liver fibrosis due to
hepatitis B by IFN-α 1 and traditional medicine preparation. World J
Gastroenterol, 1999;5:267-269
Edited by Jason Carr