Reversibility of hepatorenal syndrome (HRS) by the administration of terlipressin and albumin. A phase-II study

Úriz, J.; Ginès, Pere; Sort, Pau; Cárdenas, Andrés; Jiménez, W.; Salmerón, JM; Arroyo, V.; Rodés, Juan

doi:10.1016/s0168-8278(00)80459-6

Cited by 6 publications

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“…Moreover, based on the definite protective effect of terlipressin on GVB, the therapeutic possibilities of Frontiers in Pharmacology frontiersin.org terlipressin for GVB damage induced by bacterial or viral intestinal infections, inflammatory bowel disease and other pathogenic challenges deserve to be explored seriously. Actually, several authors had investigated the therapeutic effects of terlipressin in spontaneous bacterial peritonitis (Lee, Han et al, 2009), gastrointestinal bleeding (Seo, Park et al, 2014) and hepatorenal syndrome (Uriz, Ginès et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…Terlipressin, a highly selective vasopressin V1 receptor agonist, has become one of the commonly used vasoconstrictor drugs in the operating room and intensive care unit (ICU), and it successfully used in cases of septic shock (O'Brien, Clapp et al, 2002), hepatorenal syndrome (Uriz, Ginès et al, 2000), and gastrointestinal bleeding (Favalli, De Franceschi et al, 2004). Moreover, several clinical experiments are now investigating the impact of terlipressin on variceal hemorrhage (Poudel, Dhibar et al, 2022), post-hepatectomy (Li et al, 2020b), cirrhosis and ascites (Israelsen, Dahl et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Improvement of gut-vascular barrier by terlipressin reduces bacterial translocation and remote organ injuries in gut-derived sepsis

Chang

Zhang²,

Lin³

et al. 2022

Front. Pharmacol.

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Gut-vascular barrier (GVB) serves as the last barrier to limit the migration of intestinal toxins into the blood circulation. The efficacy of terlipressin (a vasopressin V1 receptor agonist) in reducing GVB and multiple organ damage in gut-derived sepsis is unknown. In this study, we hypothesized that, besides other intestinal barriers, GVB play a key role in gut-derived sepsis and terlipressin improve GVB damage and then reduce bacterial translocation and organ injuries. In vivo, a cecal ligation and puncture mouse model was established. The mice were subjected to examine the damage of GVB determined by intestinal plasmalemma vesicle-associated protein-1(PV-1) and vascular endothelial-cadherin. And the intestinal permeability was assessed by translocation of intestinal bacteria and macromolecules. In vitro, transendothelial electrical resistance (TER) during interleukin (IL)-1β stimulation was measured on endothelial cells with or without small interfering RNA targeting β-catenin (si β-catenin). Terlipressin significantly improved GVB damage and reduced translocation of intestinal macromolecules and bacteria by activating PI3K signaling. Of note, intestinal PV-1 expression was significantly correlated with translocation of macromolecules, and dramatic increase of macromolecules was observed in intestinal tissues whereas fewer macromolecules and bacteria were observed in blood, liver and lung following terlipressin treatment. In vitro, terlipressin restored TER during IL-1β stimulation and si β-catenin transfection blocked the changes delivered by terlipressin. Collectively, terlipressin alleviated GVB damage and subsequent bacterial translocation via blood vessels after sepsis challenge, resulting in reduced distant organ injuries and the responsible mechanisms may involve the activation of PI3K/β-catenin pathway.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improvement of gut-vascular barrier by terlipressin reduces bacterial translocation and remote organ injuries in gut-derived sepsis

Chang

Zhang²,

Lin³

et al. 2022

Front. Pharmacol.

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Diagnosis and treatment of acute renal failure in patients with cirrhosis

Moreau¹,

Lebrec

2007

Best Practice & Research Clinical Gastroenterology

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Hepatorenal syndrome in patients with cirrhosis

Moreau

2002

J of Gastro and Hepatol

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Type 1 hepatorenal syndrome (HRS) is a severe complication of end-stage cirrhosis. Type 1 HRS is an acute functional renal failure (i.e. glomerular hypofiltration) with no other explanation than the presence of the circulatory and neurohumoral alterations associated with severe chronic liver disease. Plasma volume expansion does not improve renal function. In contrast, administration of the vasopressin analog terlipressin, a splanchnic and systemic vasoconstrictor, may improve renal function and be used while awaiting liver transplantation. © 2002 Blackwell Publishing Asia Pty LtdKey words : cirrhosis, renal failure, vasoconstrictors. DEFINITIONS AND DIAGNOSISHepatorenal syndrome (HRS) is a renal failure which complicates end-stage cirrhosis with ascites. [1][2][3][4][5] There are two clinical types of HRS: type 1 and 2. 2 Type 1 HRS is characterized by the development of acute renal failure; that is, a doubling of initial serum creatinine to levels above 130 µ mol/L or a 50% decrease in the initial 24-h creatinine clearance to below 20 mL/min in less than 2 weeks. 2 Patients with type 1 HRS are in poor condition. Type 2 HRS is characterized by moderate and stable renal failure in patients who have a better condition than those with type 1 HRS. 2 This review will focus on the mechanisms, diagnosis, prognosis and treatment of type 1 HRS, and the term HRS will be used instead of type 1 HRS.Information on the frequency of HRS is controversial. In a large North American study of 3860 patients with ascites, HRS was diagnosed in less than 1% of patients. 6 Another study of 234 non-azotemic patients with ascites showed that the probability of developing HRS was 20% and 40% at 1 and 5 years, respectively. 7

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Reversibility of hepatorenal syndrome (HRS) by the administration of terlipressin and albumin. A phase-II study

Cited by 6 publications

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Improvement of gut-vascular barrier by terlipressin reduces bacterial translocation and remote organ injuries in gut-derived sepsis

Improvement of gut-vascular barrier by terlipressin reduces bacterial translocation and remote organ injuries in gut-derived sepsis

Diagnosis and treatment of acute renal failure in patients with cirrhosis

Hepatorenal syndrome in patients with cirrhosis

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