Endothelin is the most potent endogenous vasoconstrictor
yet, identified. It is a 21 aminoacid peptide secreted
by the vascular endothelium of many organs like kidneys,
lungs, brain and heart. It modulates vasomotor tone,
cell proliferation and hormone production. Our study focussed
on the possible role of endothelin in the pathogenesis
of portal hypertension and in hepatorenal syndrome as
well as its role in different liver diseases. This study included
75 Egyptian patients presenting with different liver
diseases among whom 31 cases associated with PH and 18
with FIRS. 10 subjects were included as control cases. All
subjects were examined clinically and fully investigated to
establish their diagnosis. PEC was found to be higher in
patients with bleeding oesophageal varices. Also, there
was a significant positive correlation between PEC and
portal vein diameter. PEC was higher in those patients
with HRS compared with cirrhotic patients with normal
renal functions, Yet; both had higher levels than normal
controls being 10 folds higher in cases with HRS and 3-4
folds higher in cirrhotic patients. It was to be noted that
PEC was significantly correlated with renal as well as liver
functions tests. It is to be concluded that PEC could be
found related to the severity of chronic liver diseases specially
in conditions associated with PH as well as FIRS.
This may have diagnostic and prognostic values and may
be used as a marker for progression of the disease. A contineous
studies must be done on the endothelin receptor
antagonists which may be beneficial in controlling both
portal hypertension and hepatorenal syndrome. |
