Portal Hypertension as Immune Mediate Disease

Context: portal hypertension (ph) is a progressive complication due to chronic liver disease. in addition to pathophysiologic changes in the micro-circulation, in ph are established fibrous tissue (periportal fibrous septal) and regenerative hyperplastic nodules (from micro- to macro-nodules) promoting hepatic architectural distortion. evidence acquisition: a literature search of electronic databases was undertaken for the major studies published from 1981 to today. the databases searched were: pubmed, embase, orphanet, midline and cochrane library. we used the keywords: portal hypertension, children, immune system, endocrine system, liver fibrosis. results: it is believed that ph results from three “phenotype”: ischemia-reperfusion, involving nervous system (ns); edema and oxidative damage, involving immune system; inflammation and angiogenesis, involving endocrine system. however, its exact cause still underdiagnosed and unknown. conclusions: ph is a dynamic and potentially reversible process. researchers have tried to demonstrate mechanisms underlying ph and its related-complications. this review focuses on the current knowledge regarding the pathogenesis, and immune, endocrine-metabolic factors of disease. the strong positive association between immune system and development of ph could be efficient to identify non-invasive markers of disease, to modify prognosis of ph, and to development and application of specific and individual anti-inflammatory therapy.