Hepatology International

, Volume 12, Supplement 1, pp 112–121 | Cite as

Novelties in the pathophysiology and management of portal hypertension: new treatments on the horizon

  • Seong Hee Kang
  • Moon Young Kim
  • Soon Koo Baik
Special Issue - Portal Hypertension


Portal hypertension (PH) is responsible for the most severe complications of cirrhosis and leading cause of death and liver transplantation. The standard pharmacological treatment available for PH currently consists of the use of a non-selective beta-blocker. However, a significant proportion of patients do not respond to pharmacological treatment. This has led to the development of identifiable targets for the discovery of new horizons in PH treatment. Recently, there has been significant progress in understanding the mechanism behind PH, which is a product of increased hepatic vascular resistance including structural changes and functional change due to endothelial dysfunction. Moreover, increased portal inflow is the outcome of dilation of splanchnic vessels and hyperdynamic circulation. Here, challenges in formulating potential pharmacological treatment as well as current potential targets for PH will be reviewed. During the past decades, there have been many efforts to explore new techniques to stimulate liver regeneration in addition to pharmacological treatment. The bone marrow (BM) stem cells which differentiate into mature hepatocytes are thought to contribute to liver regeneration and have been found to demonstrate great potential as regenerative medicine in different therapeutic applications. Based on these insights, we explore the current and potential novel therapeutic uses of BM stem cell therapy in PH.


Portal hypertension Hepatic vascular resistance Portal pressure Pharmacological treatment Bone marrow stem cell 



Angiotensin-II receptor blockade




Bone marrow


Bone marrow-derived mesenchymal stem/stromal cells




Endothelial NO synthase


Farnesoid X receptor


Hepatocellular carcinoma


Hematopoietic stem cells


Hepatic stellate cells


Hepatic vascular resistance


Hepatic venous pressure gradient






Mesenchymal stem/stromal cells


Nitric oxide


Non-selective beta-blocker


Obeticholic acid




Platelet-derived growth factor


Portal hypertension


Renin–angiotensin–aldosterone system


Randomized control trial


Recombinant human manganese superoxide dismutase


Superoxide dismutase


Transforming growth factor receptor


Thromboxane A2


Vascular endothelial growth factor


Compliance with ethical standards

Conflict of interest

Soon Koo Baik has received research grants of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) and the Ministry of Health & Welfare, Republic of Korea (HI15C2364). Moon Young Kim declares that he has no conflict of interest. Seong Hee Kang declares that she has no conflict of interest.

Informed consent in studies with human subjects

This article does not contain any studies with human or animal subjects.


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Copyright information

© Asian Pacific Association for the Study of the Liver 2017

Authors and Affiliations

  • Seong Hee Kang
    • 1
  • Moon Young Kim
    • 1
    • 2
  • Soon Koo Baik
    • 1
    • 2
    • 3
  1. 1.Department of Internal MedicineYonsei University Wonju College of MedicineWonjuKorea
  2. 2.Cell Therapy and Tissue Engineering CenterYonsei University Wonju College of MedicineWonjuKorea
  3. 3.Institute of Evidence Based MedicineYonsei University Wonju College of MedicineWonjuKorea

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