NITRO-OXIDATIVE STRESS, VEGF AND MMP-9 IN PATIENTS WITH CIRRHOTIC AND NON-CIRRHOTIC PORTAL HYPERTENSION
Background and aims. Nitro-oxidative stress may have pathophysiologicalconsequences. The study aimed to assess the nitro-oxidative stress, the vascular growthfactor, and metalloproteinase-9 levels in patients with noncirrohic and cirrhotic portalhypertension.Methods. Patients with noncirrhotic portal hypertension (n=50) and cirrhoticportal hypertension (n=50) from the 3rd Medical Clinic in Cluj-Napoca Romania wereprospectively enrolled between October 2004 and October 2006. A control group ofhealthy volunteers (n=50) was also evaluated. Nitro-oxidative stress was assessed bymeasuring serum concentration of nitrites and nitrate, 3-nitrotyrosine, total oxidativestatus, total antioxidant reactivity, and oxidative stress index. Serum vascular growthfactor and matrix metalloproteinase-9 were also determined.Results. Serum nitrites and nitrate levels significantly increased in bothnoncirrhotic (p<0.001) and cirrhotic portal hypertension (p=0.057). 3-nitrotyrosinealso increased in noncirrhotic (p=0.001) and cirrhotic portal hypertension patients(p=0.014). Total oxidative status showed a significant increase in noncirrhotic (p<0.001)and in cirrhotic portal hypertension (p<0.001), but total antioxidant reactivity did not changesignificantly. The oxidative stress index increased in both noncirrhotic (p <0.001) and cirrhoticportal hypertension (p<0.001), as well as the serum vascular growth factor (p=0.005 andp=0.01, respectively). In NCPHT patients serum MMP-9 was significantly lower than inthe healthy controls (p=0.03) and CPHT patients (p=0.05).Conclusion. In patients with noncirrhotic and cirrhotic portal hypertension asignificant systemic nitro-oxidative stress was found, correlated with an increase ofVEGF. MMP-9 decreased in noncirrhotic portal hypertension.