Functionality of beta-adrenergic receptors in patients with cirrhosis treated chronically with non-selective beta-blockers

Almenara, Susana; Lozano, Beatriz Rodríguez; Giménez, Paula; Herrera, Iván; Miralles, Cayetano; Bellot, Pablo; Rodríguez, Maria M.; Francés, Rubén; González‐Navajas, José M.; Pascual, Sonia; Zapater, Pedro

doi:10.1007/s12072-020-10083-5

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…The window hypothesis, as proposed by Krag et al, suggests that the benefit windows of NSBBs may be closed once patients develop refractory ascites [17]. It may be explained that proinflammatory cytokines are increased in the splanchnic compartment among patients with refractory ascites, in whom chronic inflammation may cause decreased expression of β-adrenergic receptors and sympathetic nerve fiber loss, thereby leading to diminished effects of NSBBs [39]. However, several recent studies to investigate the efficacy of NSBBs in patients with ascites have reported opposite results.…”

Section: Ascites and Refractory Ascitesmentioning

confidence: 99%

Non-Selective Beta-Blockers in Patients with Cirrhosis: Current Evidence and Controversy

Wang,

et al. 2024

Liver Cirrhosis and Its Complications - Advances in Diagnosis and Management

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Non-selective beta-blockers (NSBBs) are the cornerstone of management of liver cirrhosis and its complications. They decrease portal vein blood flow and portal vein pressure via antagonism of β1 and β2 receptors, thereby improving the hyperdynamic circulatory status and reducing the risk of decompensated events in cirrhotic patients with portal hypertension (PH). Currently, NSBBs have been recommended for the primary and secondary prevention of variceal bleeding in patients with cirrhosis. Nevertheless, it has been noted that the clinical risk-benefit ratio appears to deteriorate for NSBBs in patients with advanced liver cirrhosis. Considering that the use of NSBBs in the clinical practice of cirrhotic patients remains controversial, this chapter aims to summarize the evidence of current recommendations and controversies regarding the use of NSBBs in patients with cirrhosis.

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Section: Ascites and Refractory Ascitesmentioning

confidence: 99%

Non-Selective Beta-Blockers in Patients with Cirrhosis: Current Evidence and Controversy

Wang,

et al. 2024

Liver Cirrhosis and Its Complications - Advances in Diagnosis and Management

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“…Also, the incidence of spontaneous bacterial peritonitis (SBP) decreases under NSBB (103) and NSBB favorably affect at least the short-term prognosis of patients with acute on chronic liver failure (ACLF) (104). This may be explained by effects on the intestinal motility (105), but also by a direct receptormediated effect on immune cell signaling (95,(106)(107)(108)(109). On the other hand, at least in inflammatory models, ß 2 -blockade has a proinflammatory effect on the kidney (32,110).…”

Section: Nsbbs and Inflammationmentioning

confidence: 99%

Beta-blockers in patients with liver cirrhosis: Pragmatism or perfection?

et al. 2023

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With increasing decompensation, hyperdynamic circulatory disturbance occurs in liver cirrhosis despite activation of vasoconstrictors. Here, the concept of a therapy with non-selective beta-blockers was established decades ago. They lower elevated portal pressure, protect against variceal hemorrhage, and may also have pleiotropic immunomodulatory effects. Recently, the beneficial effect of carvedilol, which blocks alpha and beta receptors, has been highlighted. Carvedilol leads to “biased-signaling” via recruitment of beta-arrestin. This effect and its consequences have not been sufficiently investigated in patients with liver cirrhosis. Also, a number of questions remain open regarding the expression of beta-receptors and its intracellular signaling and the respective consequences in the intra- and extrahepatic tissue compartments. Despite the undisputed role of non-selective beta-blockers in the treatment of liver cirrhosis, we still can improve the knowledge as to when and how beta-blockers should be used in which patients.

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Immune changes over time and survival in patients with cirrhosis treated with non-selective beta-blockers: A prospective longitudinal study

Almenara

Lozano-Ruiz

Herrera

et al. 2023

Biomedicine & Pharmacotherapy

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Functionality of beta-adrenergic receptors in patients with cirrhosis treated chronically with non-selective beta-blockers

Cited by 4 publications

References 25 publications

Non-Selective Beta-Blockers in Patients with Cirrhosis: Current Evidence and Controversy

Non-Selective Beta-Blockers in Patients with Cirrhosis: Current Evidence and Controversy

Beta-blockers in patients with liver cirrhosis: Pragmatism or perfection?

Immune changes over time and survival in patients with cirrhosis treated with non-selective beta-blockers: A prospective longitudinal study

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