Rabbit model of non‐cirrhotic portal fibrosis with repeated immunosensitization by rabbit splenic extract

Kathayat, R; Pandey, Geeta; Malhotra, Veena; Omanwar, Swati; Sharma, Bharti; Sarin, Shiv Kumar

doi:10.1046/j.1440-1746.2002.02882.x

Cited by 24 publications

(20 citation statements)

References 19 publications

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“…Recently, a rabbit model of NCPF has been developed by repeated injection of E. coli through an indwelling cannula into the gastrosplenic vein. These animals show marked portal hypertension with peripheral vasodilation and obtunded response to vasoactive agents [22]. This information further substantiates that in NCPF, a state of hyperdynamic circulation exists and all major circulatory beds, the splanchnic, cardiac, pulmonary and systemic are affected.…”

Section: Discussionsupporting

confidence: 72%

Systemic and pulmonary hemodynamics in patients with non-cirrhotic portal fibrosis (NCPF) is similar to compensated cirrhosis

et al. 2007

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Background Non-cirrhotic portal fibrosis (NCPF) is an important cause of portal hypertension (PHT) and variceal bleeding, especially in the developing countries. While the hepatic parenchyma and liver functions are normal, the patho-anatomic defect in these patients is pre-and peri-sinusoidal in nature. Aim To study the systemic and pulmonary hemodynamic alterations in patients with NCPF and compare them with compensated cirrhotic patients. Patients and Methods Patients with NCPF (n = 20, mean age 29.3 ± 9.8 year) and matched Child's A cirrhotic patients (n = 17, age 34.1 ± 9.8 year) who had bled in the past, underwent hemodynamic measurements using a balloon tipped catheter. Results In NCPF patients, the hepatic venous pressure gradient (HVPG) was significantly lower than in the cirrhotic patients (4.9 ± 1.5 mmHg vs. 15.7 ± 4.5 mmHg; P < 0.01). NCPF patients had hyperdynamic circulation and peripheral vasodilatation comparable to cirrhotic patients; cardiac output (8.0 ± 1.2 l/min vs. 8.4 ± 1.9 l/ min; P = 0.4), cardiac index (5.4 ± 0.8 l/min/m 2 vs. 5.5 ± 1.9 l/min/m ; P = 0.95) were comparable in the two groups. Conclusions NCPF associated portal hypertension leads to a hyperdynamic state with high cardiac index and low systemic and pulmonary vascular resistance comparable to compensated cirrhosis. These novel observations suggest a primary role of portal hypertension in the development of hyperdynamic state.

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Section: Discussionsupporting

confidence: 72%

Systemic and pulmonary hemodynamics in patients with non-cirrhotic portal fibrosis (NCPF) is similar to compensated cirrhosis

et al. 2007

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“…Repeated intramuscular injection of splenic extract was shown [51] to produce significant splenomegaly and rise in portal pressure at 1, 3, and 6 months without hepatic parenchymal injury, quite akin to NCPF seen in humans.…”

Section: Repeated Immunosensitization By Rabbit Splenic Extractmentioning

confidence: 93%

Noncirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and treatment

et al. 2007

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The Asian Pacific Association for the Study of the Liver (APASL) Working Party on Portal Hypertension has developed consensus guidelines on the disease profile, diagnosis, and management of noncirrhotic portal fibrosis and idiopathic portal hypertension. The consensus statements, prepared and deliberated at length by the experts in this field, were presented at the annual meeting of the APASL at Kyoto in March 2007. This article includes the statements approved by the APASL along with brief backgrounds of various aspects of the disease.

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“…Idiopathic portal hypertension like changes in the liver and the development of portal hypertension have been reported after injecting dead non‐pathogenic colon bacilli into the portal vein of rabbits and dogs 18,19 . Recently in a model of indwelling cannulation of gastrosplenic vein, we showed that repeated injections of Escherichia coli resulted in development of splenomegaly and rise in portal pressure at 3 months 20 …”

Section: Etiopathogenesismentioning

confidence: 97%

Non‐cirrhotic portal fibrosis

Sarin

2002

J of Gastro and Hepatol

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Non‐cirrhotic portal hypertension (NCPH) comprises of diseases having an increase in portal pressure (PP) due to intraheptic or prehepatic lesions, in the absence of cirrhosis. The lesions are generally vascular, either in the portal vein, its branches or in the perisinusoidal area. Because the wedged hepatic venous pressure (WHVP) is near normal, measurement of intravariceal or intrasplenic pressure is needed to assess portal pressure. The majority of the diseases included in the category of NCPH are well characterized disease entities where portal hypertension (PHT) is a late manifestation and hence, these are not discussed. Two diseases which present only with features of PHT and are common in developing countries are NCPF and extra‐hepatic portal vein obstruction (EHPVO). Non‐cirrhotic portal fibrosis is a syndrome of obscure etiology, characterized by ‘Obliterative portovenopathy’ leading to PHT, massive splenomegaly, repeated well tolerated episodes of variceal bleeding and anemia in young adults from low socio‐economic strata of life. The hepatic parenchymal functions are nearly normal. Jaundice, ascites and hepatic encephalopathy are rare. Management of variceal bleeding remains the main concern as nearly 85% of patients with NCPF present with variceal bleeding. Endoscopic variceal ligation or sclerotherapy are equally effective in about 90–95% of the patients. Gastric varices are seen in about 25% patients and a bleed from them can be managed with cyanoacrylate glue injection or surgery. Other indications for surgery include failure of endoscopic therapy to control acute bleed and symptomatic hypersplenism. The prognosis of patients with NCPF is good and 5‐years survival rates in patients in whom variceal bleeding can be controlled is about > 95%. © 2002 Blackwell Publishing Asia Pty Ltd

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Rabbit model of non‐cirrhotic portal fibrosis with repeated immunosensitization by rabbit splenic extract

Abstract: This animal model showed significant splenomegaly, with persistent rise in portal pressure without hepatic parenchymal injury, quite akin to NCPF seen in humans. This study also proposes that repeated immunostimulation may have an important role in the pathogenesis of NCPF.

Cited by 24 publications

References 19 publications

Systemic and pulmonary hemodynamics in patients with non-cirrhotic portal fibrosis (NCPF) is similar to compensated cirrhosis

Systemic and pulmonary hemodynamics in patients with non-cirrhotic portal fibrosis (NCPF) is similar to compensated cirrhosis

Noncirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and treatment

Non‐cirrhotic portal fibrosis

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