Beta-blockers display anti-inflammatory effects in advanced liver disease

December 10, 2020

Approximately 170,000 people die every year in Europe from the direct consequences of advanced chronic liver disease (cirrhosis). In Austria, cirrhosis of the liver is usually due to a fatty liver resulting from excessive alcohol consumption or overeating and/or poor diet and - thanks to effective antiviral therapies - less common due to viral hepatitis.

Chronic liver damage leads to scarring (fibrosis) of the liver tissue, which can ultimately lead to increased blood pressure in the vascular system of the gastrointestinal tract (i.e. portal hypertension).

Portal hypertension can result in serious complications such as ascites and variceal bleeding. A paper recently published by Thomas Reiberger's research group at MedUni Vienna has already shown that increasing severity of portal hypertension is paralleled by inflammatory reactions in the body (systemic inflammation). Pronounced systemic inflammation may ultimately trigger the development of serious complications, such as acute-on-chronic liver failure.

Beta-blocker treatment and portal vein pressure measurement at MedUni Vienna

For many years, beta-blockers have been used as a standard drug treatment but only 50% to 60% of patients achieve a clinically relevant reduction in portal vein pressure. It is therefore necessary to assess the hemodynamic response invasively by means of hepatic vein catheterisation. Over the last few years, beta-blocker therapy and the invasive technique of hemodynamic measurements have been continuously optimised in the Vienna Hepatic Haemodynamic Laboratory at the Division of Gastroenterology and Hepatology of the Department of Medicine III of MedUni Vienna and Vienna General Hospital. Head of the Vienna Hepatic Haemodynamic Laboratory, Thomas Reiberger, explains: "We use portal pressure measurements to ensure that our patients with liver cirrhosis receive both best diagnosis and effective beta-blocker therapy."

Anti-inflammatory effects of beta-blockers in cirrhosis

The recently published study shows for the first time that beta-blockers also have an impact on systemic inflammation. For this study, the researchers determined biomarkers of systemic inflammation prior to and subsequently during ongoing treatment with beta-blockers. This showed that patients suffering from advanced stages of cirrhosis were not only more likely to display a pronounced systemic inflammatory response but were also more likely to benefit from the anti-inflammatory effects of beta-blockers. It was observed that cirrhotic patients who achieve a relevant reduction in inflammatory markers (such as the white blood cell count) under beta-blocker therapy developed significantly fewer complications of portal hypertension and had a lower risk of liver-related mortality.

"After further validation in clinical trials, these promising data may help us to predict the individual benefit of beta-blocker treatment more accurately and thus to give our patients optimal advice regarding their prognosis and other treatment options," explains Mathias Jachs, who was mainly responsible for the study as lead author. The study findings were published in the journal Gut, one of the leading international journals in the field of gastroenterology and hepatology.
-end-


Medical University of Vienna

Related Cirrhosis Articles from Brightsurf:

Researchers discover gene that could decrease likelihood of developing alcoholic cirrhosis
Researchers at Indiana University School of Medicine are learning more about how a person's genes play a role in the possibility they'll suffer from alcoholic cirrhosis with the discovery of a gene that could make the disease less likely.

When liver cirrhosis is deadly
A study by an international team of researchers headed by Professor Jonel Trebicka from the Frankfurt University Hospital and funded by the foundation EF Clif, has discovered which patients are particularly at risk for acute-on-chronic liver failure.

Blood tests can predict the risk of liver cirrhosis
Repeated measurements of the biomarker FIB-4 in the blood every few years can predict the risk of developing severe liver disease, according to a new study from Karolinska Institutet in Sweden published in the Journal of Hepatology.

Universal gut microbiome-derived signature predicts cirrhosis
UC San Diego School of Medicine researchers report that stool microbiomes of NAFLD patients are distinct enough to potentially be used to accurately predict which persons with NAFLD are at greatest risk for having cirrhosis.

Strength training benefits patients with cirrhosis
Three hours of weekly strength training combined with protein supplements leads to both bigger and stronger muscles in patients with cirrhosis.

Women are not more likely to die of cirrhosis than men, despite fewer liver transplants
Prior studies suggested women might have higher mortality of cirrhosis of the liver than men.

Movement toward a poop test for liver cirrhosis
In a study of people with nonalcoholic fatty liver disease and their twins and other close relatives, UC San Diego researchers were able to diagnose liver cirrhosis simply by analyzing a person's stool microbes.

Gum disease treatment may improve symptoms in cirrhosis patients
Routine oral care to treat gum disease (periodontitis) may play a role in reducing inflammation and toxins in the blood (endotoxemia) and improving cognitive function in people with liver cirrhosis.

Alcohol-related cirrhosis deaths skyrocket in young adults
Liver disease deaths jumped by 65 percent in the United States, from 1999-2016, disproportionately affecting adults ages 25-34.

Researchers find a promising new approach for treating liver cirrhosis
In a study in The American Journal of Pathology, investigators report that treatment with aleglitazar, a dual peroxisome proliferator-activated receptor-alpha/gamma (PPARα/γ) agonist, reduced inflammation, vasoconstriction, angiogenesis, mucosal disruption, and tumor necrosis factor (TNF)-α overproduction in cirrhotic rats with PH.

Read More: Cirrhosis News and Cirrhosis Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.