A study in the America Journal of Physiology suggests that a drug indicated for the treatment of type 2 diabetes can improve portal hypertension in cirrhotic animals after one week of treatment, potentially leading the way for clinical trials in humans.
In this research, cirrhosis with intrahepatic portal hypertension and secondary biliary cirrhosis with intrahepatic portal hypertension was experimentally induced in a set of rats. The rats received metformin 300mg/kg or its vehicle once daily for one week; their mean arterial pressure (MAP), portal pressure (PP), portal blood flow (PBF), hepatic vascular resistance (HVR), and putative molecular/cellular mechanisms were then measured.
The rats with cirrhosis with intrahepatic portal hypertension treated with metformin had portal pressure that was 27% lower than in those receiving the vehicle. The reduction in portal pressure was not associated with modifications in portal blood flow, which could indicate decreased hepatic vascular resistance. A significant reduction was also seen in liver fibrosis (greater in the cirrhosis with intrahepatic portal hypertension rats) and hepatic inflammation. After propranolol administration, even greater improvements were observed compared to placebo, with no differences in systemic hemodynamics.
Metformin plus propranolol could become a new therapeutic approach to treating portal hypertension in patients with cirrhosis, the authors concluded, but the results need to be confirmed in clinical trials.
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