caa a22 4500 445889330 CHVBK 20180317145610.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1007/s00535-011-0449-z doi (NATIONALLICENCE)springer-10.1007/s00535-011-0449-z Effects of 1-year administration of olmesartan on portal pressure and TGF-beta1 in selected patients with cirrhosis: a randomized controlled trial [Elektronische Daten] [Hisashi Hidaka, Takahide Nakazawa, Akitaka Shibuya, Tsutomu Minamino, Juichi Takada, Yoshiaki Tanaka, Yusuke Okuwaki, Masaaki Watanabe, Wasaburo Koizumi] Background: The renin-angiotensin system plays an important role in hepatic fibrosis and portal hypertension. We evaluated the long-term effects of olmesartan, an angiotensin type 1 (AT1) receptor blocker, on hemodynamics and liver fibrosis. Methods: Forty-eight selected patients with cirrhosis were randomly divided into two groups of 24 patients each, those who received and those who did not receive olmesartan treatment for 1year. Hepatic hemodynamic studies, and measurements of transforming growth factor-beta1 (TGF-beta1) and blood markers of hepatic fibrosis, including serum hyaluronic acid (HA), type IV collagen, and procollagen III N-terminal propeptide levels, were also performed at the beginning and end of the study. Results: The median dose of the final drug administration was 20mg (range 10-40mg). Olmesartan reduced the hepatic venous pressure gradient (HVPG) by −12.9±9.1% (p=0.035) after 1year. No significant changes were seen in controls. Six of the 24 patients (25%) in the olmesartan group showed a >20% reduction of HVPG from baseline values. TGF-beta1 was significantly decreased in patients who received olmesartan (7.0±8.2 vs. 3.1±1.6ng/mL, p=0.046) but there was no decrease in the controls. A significant trend was shown by correlating HA and TGF-beta1 variations in cirrhosis patients (p=0.018, r=0.377). Fibrosis markers were unchanged at the end of the study in both groups. Conclusions: Olmesartan induced a mild reduction of portal pressure and TGF-beta1 for 1year, but did not suppress hepatic fibrosis markers. Springer, 2011 Angiotensin type 1 receptor blocker nationallicence Hepatic fibrosis nationallicence Hepatic venous pressure gradient nationallicence Liver cirrhosis nationallicence TGF-beta1 nationallicence TGF-beta1 : Transforming growth factor-beta1 nationallicence AT1 : Angiotensin type 1 nationallicence HA : Hyaluronic acid nationallicence HVPG : Hepatic venous pressure gradient nationallicence Ang II : Angiotensin II nationallicence RAS : Renin-angiotensin system nationallicence HSC : Hepatic stellate cell nationallicence NASH : Nonalcoholic steatohepatitis nationallicence ARB : Angiotensin receptor blocker nationallicence PIIINP : Procollagen III N-terminal propeptide nationallicence MAP : Mean arterial pressure nationallicence ELISA : Enzyme-linked immunosorbent assay nationallicence HABP : Hyaluronic acid binding protein nationallicence RIA : Radioimmunoassay nationallicence EIA : Enzyme immunoassay nationallicence WHVP : Wedged hepatic venous pressure nationallicence FHVP : Free hepatic vein pressure nationallicence NSBB : Nonselective beta-blocker nationallicence Hidaka Hisashi Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut Nakazawa Takahide Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut Shibuya Akitaka Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut Minamino Tsutomu Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut Takada Juichi Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut Tanaka Yoshiaki Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut Okuwaki Yusuke Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut Watanabe Masaaki Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut Koizumi Wasaburo Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut Journal of Gastroenterology Springer Japan 46/11(2011-11-01), 1316-1323 0944-1174 46:11<1316 2011 46 535 https://doi.org/10.1007/s00535-011-0449-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-011-0449-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hidaka Hisashi Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut NATIONALLICENCE 700 1- Nakazawa Takahide Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut NATIONALLICENCE 700 1- Shibuya Akitaka Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut NATIONALLICENCE 700 1- Minamino Tsutomu Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut NATIONALLICENCE 700 1- Takada Juichi Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut NATIONALLICENCE 700 1- Tanaka Yoshiaki Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut NATIONALLICENCE 700 1- Okuwaki Yusuke Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut NATIONALLICENCE 700 1- Watanabe Masaaki Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut NATIONALLICENCE 700 1- Koizumi Wasaburo Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/11(2011-11-01), 1316-1323 0944-1174 46:11<1316 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer