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

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.