Role of circulating angiogenin levels in portal hypertension and TIPS

PLoS One. 2021 Aug 25;16(8):e0256473. doi: 10.1371/journal.pone.0256473. eCollection 2021.

Abstract

Background: Pathogenesis of portal hypertension is multifactorial and includes pathologic intrahepatic angiogenesis, whereby TIPS insertion is an effective therapy of portal hypertension associated complications. While angiogenin is a potent contributor to angiogenesis in general, little is known about its impact on TIPS function over time.

Methods: In a total of 118 samples from 47 patients, angiogenin concentrations were measured in portal and inferior caval vein plasma at TIPS insertion (each blood compartment n = 23) or angiographic intervention after TIPS (each blood compartment n = 36) and its relationship with patient outcome was investigated.

Results: Angiogenin levels in the inferior caval vein were significantly higher compared to the portal vein (P = 0.048). Ten to 14 days after TIPS, inferior caval vein angiogenin level correlated inversely with the portal systemic pressure gradient (P<0.001), measured invasively during control angiography. Moreover, patients with TIPS revision during this angiography, showed significantly lower angiogenin level in the inferior caval vein compared to patients without TIPS dysfunction (P = 0.01).

Conclusion: In cirrhosis patients with complications of severe portal hypertension, circulating levels of angiogenin are derived from the injured liver. Moreover, angiogenin levels in the inferior caval vein after TIPS may predict TIPS dysfunction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiography
  • Area Under Curve
  • Follow-Up Studies
  • Humans
  • Hypertension, Portal / blood*
  • Hypertension, Portal / surgery*
  • Inflammation / blood
  • Inflammation / pathology
  • Leukocyte Count
  • Middle Aged
  • Portasystemic Shunt, Transjugular Intrahepatic*
  • ROC Curve
  • Ribonuclease, Pancreatic / blood*
  • Vena Cava, Inferior / surgery

Substances

  • angiogenin
  • Ribonuclease, Pancreatic

Grants and funding

The authors were supported by grants from the Deutsche Forschungsgemeinschaft (SFB TRR57 Project ID 36842431, CRC1382 Project-ID 403224013), Cellex Foundation, and European Union’s Horizon 2020 research and innovation program’s GALAXY study (No. 668031), LIVERHOPE (No. 731875) and MICROB-PREDICT (No. 825694). The manuscript reflects only the authors’ views, and the European Commission is not responsible for any use that may be made of the information it contains. The funders had no influence on study design, data collection and analysis, decision to publish or preparation of the manuscript.