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Urotensin II: a novel vasoactive mediator linked to chronic liver disease and portal hypertension


Dr William Kemp, Gastroenterology Department, Alfred Hospital, Commercial Rd, Melbourne, Australia 3004.
Tel: +61 3 90762223
Fax: +61 3 90762194


Background/Aims: Urotensin II (UII) is recognised as the most potent human vasoconstrictor; however, its role in chronic liver disease (CLD) is unknown.

Aim: We sought to determine serum UII levels in CLD and explore its relationship with clinical features and outcomes of patients with CLD and portal hypertension.

Methods: UII was analysed by radio-immunoassay on cirrhotic patients undergoing hepatic venous pressure gradient (HVPG) determination and age- and sex-matched controls. Follow-up data were prospectively recorded.

Results: From 1997 to 2004, 80 patients (male/female: 74/6) underwent a total of 94 HVPG assessments. UII was higher in cirrhotic patients compared with controls (2.05±0.06 and 1.55±0.09 pmol/L, P<0.001) and was correlated with HVPG (r=+0.35, P=0.001) and severity of CLD (r=+0.6, P<0.001). UII was higher in patients who developed refractory ascites (2.45±0.13 vs. 1.7±0.12 pmol/L, P<0.001) and in those who died during the follow-up period (2.27±0.15 pmol/L vs. 1.95±0.08 pmol/L, P<0.05).

Conclusion: Serum UII is elevated in patients with CLD, and is associated with the severity of the underlying liver disease and the degree of portal hypertension. Baseline levels can predict future complications such as refractory ascites and patient survival.