Reversion of liver cirrhosis after endovascular treatment in Chinese patients with Budd–Chiari syndrome

Abstract

AimsTo investigate the impact of endovascular (EV) treatment on liver cirrhosis in Chinese patients with Budd‐Chiari syndrome (BCS).MethodsFrom September 2011 to March 2022, 97 patients from four hospitals in China who were diagnosed with primary BCS complicated with liver cirrhosis and received EV treatment were retrospectively enrolled in this study for clinical analysis. In addition, liver tissues for basic research were acquired from 25 patients between June 2022 and March 2023, including 6 with benign liver tumors, 11 with BCS before EV treatment, and 8 with EV‐treated BCS. Liver cirrhosis was assessed by clinical outcomes, histological studies, and the expression of related genes at the mRNA and protein levels.ResultsThe patients with BCS had better liver function after EV treatment, evidenced by an increased albumin level and reduced total bilirubin, ALT, and AST. The imaging findings suggested an amelioration of liver cirrhosis and portal hypertension, including increased portal vein velocity (13.52±8.89cm/s vs 17.51±6.67cm/s, p<0.001) and decreased liver stiffness (30.37±6.39kPa vs 23.70±7.99kPa, p<0.001), portal vein diameter (14.97±3.42mm vs 13.36±2.89mm, p<0.001), and spleen volume (870.00±355.61cm3 vs 771.36±277.45cm3, p<0.001). Furthermore, histological studies revealed that EV treatment resulted in a restoration of liver architecture with reduced extracellular matrix deposition. Meanwhile, hepatic angiogenesis and inflammation, which have a close relationship with cirrhosis, were also inhibited. And the state of hepatocytes switches from apoptosis to proliferation after EV treatment.ConclusionsBCS‐induced liver cirrhosis could be reversed by EV treatment from macroscopic to microcosmic dimensions. Our study may provide further insights into understanding BCS and treating cirrhosis.This article is protected by copyright. All rights reserved.

Ginkgetin exhibits antifibrotic effects by inducing hepatic stellate cell apoptosis via STAT1 activation

“…The procedures of histological study (including hematoxylin and eosin [H&E] staining, Sirius red staining, TUNEL assay, immunohistochemistry [IHC], and immunofluorescence [IF]), western blot, and quantitative real‐time polymerase chain reaction (qRT‐PCR) had been described in detail in prior studies (Wang et al, 2022, 2023). The antibodies for IHC, IF, and western blot are shown in Table S1.…”

“…We performed bulk RNA‐sequencing (RNA‐Seq) analysis on the liver tissues (TAA + Veh group vs. TAA + Gink group, n = 3 per group) and LX‐2 cells (treated with DMSO or ginkgetin, n = 3 per group). The detailed procedures have been described in prior work (Wang et al, 2023). Differentially expressed genes (DEGs) were defined as |log2(fold change)| >1 and false discovery rate (FDR) <0.05.…”