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According to a new study by researchers at the Mayo Clinic, a drug treatment could effectively treat a potentially fatal disease badociated with cirrhosis and other chronic liver diseases. The study was published in March Gastroenterology, the online journal of the American Gastroenterological Association. The print publication is scheduled for July.
Although treatments are available to treat some forms of liver disease, including hepatitis C and autoimmune hepatitis, treatment options for portal hypertension have been more limited, resulting in an increase in the pressure in the portal vein that carries the organs' blood to the liver. Portal hypertension is badociated with cirrhosis and other chronic liver diseases.
According to the study, the drug sivelestat could actually reduce portal hypertension, thereby improving the symptoms and outcomes for these patients. The results of the study were obtained from mouse models but have since been confirmed in liver samples taken from humans, according to Vijay Shah, MD, Mayo Clinic's gastroenterologist and lead author.
"It was an inspiring confirmation of our discoveries and their applicability to human diseases," says Dr. Shah. "Sivelestat has been used safely in patients with acute lung injury and bronchopulmonary dysplasia, suggesting that sivelestat and similar drugs are a potential way to reduce portal hypertension in patients with chronic liver disease. "
The Mayo study showed that fibrin deposits – microvascular blood clots – contributed to portal hypertension and that inflammatory cells known as neutrophils contributed to fibrin formation. By inhibiting neutrophil function with sivelestat, they could decrease portal hypertension.
"Neutrophils have not yet been identified as significant factors in portal hypertension," says Moira Hilscher, M.D., first author of the paper. The results were verified in two different models of chronic liver disease.
"The study paves the way for the development of new drugs and the reuse of existing compounds to combat liver inflammation caused by mechanical forces related to the disease," said Dr. Hilscher . "Given the growing prevalence of advanced liver disease due to alcohol and obesity, it is clearly an unmet need."
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