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KMID : 0191120140290030392
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Journal of Korean Medical Science
2014 Volume.29 No. 3 p.392 ~ p.399
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Relationship between Tetrahydrobiopterin and Portal Hypertension in Patients with Chronic Liver Disease
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Hong Won-Ki
Shim Kwang-Yong
Baik Soon-Koo
Kim Moon-Young
Cho Mee-Yon
Jang Yoon-Ok
Park Young-Shik
Han Jin
Kim Ga-Eun
Cho Youn-Zoo
Hwang Hye-Won
Lee Jin-Hyung
Chae Myeong-Hun
Kwon Sang-Ok
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Abstract
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Tetrahydrobiopterin (BH4) is an essential cofactor in NO synthesis by endothelial nitric oxide synthase (eNOS) enzymes. It has been previously suggested that reduced intrahepatic BH4 results in a decrease in intrahepatic NO and contributes to increased hepatic vascular resistance and portal pressure in animal models of cirrhosis. The main aim of the present study was to evaluate the relationship between BH4 and portal hypertension (PHT). One hundred ninety-three consecutive patients with chronic liver disease were included in the study. Liver biopsy, measurement of BH4 and hepatic venous pressure gradient (HVPG) were performed. Hepatic fibrosis was classified using the Laennec fibrosis scoring system. BH4 levels were determined in homogenized liver tissues of patients using a high performance liquid chromatography (HPLC) system. Statistical analysis was performed to evaluate the relationship between BH4 and HVPG, grade of hepatic fibrosis, clinical stage of cirrhosis, Child-Pugh class. A positive relationship between HVPG and hepatic fibrosis grade, clinical stage of cirrhosis and Child-Pugh class was observed. However, the BH4 level showed no significant correlation with HVPG or clinical features of cirrhosis. BH4 concentration in liver tissue has little relation to the severity of portal hypertension in patients with chronic liver disease.
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KEYWORD
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Hypertension, Portal, Nitric Oxide, Liver Cirrhosis
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