β-arrestin-2 predicts the clinical response to β-blockers in cirrhotic portal hypertension patients: A prospective study.

Autor:	Lashen SA; Division of Hepatology and Gastroenterology, Faculty of Medicine, Alexandria University, Alexandria 21521, Egypt. sameh.lashen@alexmed.edu.eg., Shamseya MM; Department of Experimental and Clinical Internal Medicine, Medical Research Institute, Alexandria 21561, Egypt., Madkour MA; Department of Experimental and Clinical Internal Medicine, Medical Research Institute, Alexandria 21561, Egypt., Abdel Salam RM; Department of Pathology, Medical Research Institute, Alexandria University, Alexandria 21561, Egypt., Mostafa SS; Department of Pathology, Medical Research Institute, Alexandria University, Alexandria 21561, Egypt.
Jazyk:	angličtina
Zdroj:	World journal of hepatology [World J Hepatol] 2022 Feb 27; Vol. 14 (2), pp. 429-441.
DOI:	10.4254/wjh.v14.i2.429
Abstrakt:	Background: Portal hypertension, a common complication associated with liver cirrhosis, can result in variceal bleeding, which greatly impacts patient survival. Recently, β-arrestin-2 has been shown to predict the acute hemodynamic response to nonselective β-blocker therapy for cirrhotic portal hypertension. However, more data is needed on the long-term effects of and changes in β-arrestin-2 following nonselective β-blocker therapy. Aim: To investigate the expression and role of β-Arrestin-2 in predicting the long-term response to nonselective β-blockers in cirrhotic portal hypertensive patients. Methods: We prospectively enrolled 91 treatment-naïve patients with cirrhotic portal hypertension. Baseline clinical and laboratory data were obtained. Gastroscopy was performed for grading and treating varices and obtaining gastric antral biopsies. We measured the serum and antral expression of β-arrestin-2 and obtained Doppler measurement of the portal vein congestion index. Treatment with nonselective β-blockers was then started. The patients were followed up for 18 mo, after which they have undergone a repeat antral biopsy and re-evaluation of the portal vein congestion index. Results: A higher serum level and antral expression of β-arrestin-2 was associated with longer bleeding-free intervals, greater reduction in the portal vein congestion index, and improved grade of varices. Among patients with a low β-arrestin-2 expression, 17.6% were nonselective β-blocker responders, whereas, among those with high expression, 95.1% were responders ( P < 0.001). A serum β-arrestin-2 value ≥ 2.23 ng/mL was associated with a lower likelihood of variceal bleeding (90% sensitivity and 71% specificity). β-arrestin-2 expression significantly decreased after nonselective β-blocker therapy. Conclusion: β-arrestin-2 expression in cirrhotic portal hypertension predicts the clinical response to long-term nonselective β-blocker treatment. Serum β-arrestin-2 is a potential noninvasive biomarker for selecting the candidate patients for nonselective β-blockers. Competing Interests: Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose. (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu