Evidence mapPaperPMID 26192220Full record

ReviewJournal of hepatology2015

Mechanisms of decompensation and organ failure in cirrhosis: From peripheral arterial vasodilation to systemic inflammation hypothesis.

Mauro Bernardi, Richard Moreau, Paolo Angeli, Bernd Schnabl, Vicente Arroyo

3 registry-linked trialsAbstract readReview
PubMed Publisher
In one paragraph

Review in Journal of hepatology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 255 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
255citing papers in PubMed, 4 pooled it
21.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05999773 active not recruitingstarted 2023, after this paper: background citation

Potential Role of Sodium Glucose Cotransporter 2 Inhibitors in the Treatment of Ascites in Cirrhotic Patients

Ran2023Enrolled40Registered outcomes18Posted comparisons0ConditionsAscites Hepatic, Cirrhosis, Liver, Diabete Type 2ArmsSGLT2 inhibitor
Open the trial in the graph
NCT04543643 phase3unknown statusnot on this mapstarted 2021, after this paper: background citation

Endoscopic and Microbiological Assessment of the Effect of Carvedilol Combined With Berberine on GOV in Cirrhosis: a Prospective Cohort Study

TypeinterventionalSponsorTianjin Second People's HospitalRan2021 to 2023Enrolled288ConditionsCirrhosis Due to Hepatitis B, Cirrhosis Due to Hepatitis C, Gastroesophageal VaricesArmsCarvedilol, Berberine
NCT05856721 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Pattern of Intestinal Parasitic Infection Among Cirrhotic Patients in Sohag University Hospital

TypeinterventionalSponsorSohag UniversityRan2023 to 2024Enrolled200ConditionsLiver CirrhosisArmsstool analysis
3 · Its place in the literature

Who cites it

255 citing papers in PubMed, 4 syntheses or guidelines pooled it, 615 citations in OpenAlex.

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  10. Albumin Restores Endothelial Cell Mitochondrial Morphology in Patients With Decompensated Cirrhosis.Liver international : official journal of the International Association for the Study of the Liver · 2026
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195 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 4 countries.

Mauro BernardiDepartment of Medical and Surgical Sciences - Alma Mater Studiorum, University of Bologna, Italy; Semeiotica Medica, Policlinico S. Orsola-Malpighi, Bologna, Italy. Electronic address: mauro.bernardi@unibo.it.
Richard MoreauInserm, U(1149), Centre de Recherche sur l'Inflammation (CRI), Paris, France; UMR_S(1149), Université Paris Diderot, Faculté de Médecine, Paris, France; Département Hospitalo-Universitaire (DHU) UNITY, Service d'Hépatologie, Hôpital Beaujon, AP-HP, Clichy, France.
Paolo AngeliUnit of Hepatic Emergencies and Liver Transplantation, Department of Medicine-DIMED, University of Padova, Padova, Italy.
Bernd SchnablDepartment of Medicine, University of California San Diego, La Jolla, CA, United States; Department of Medicine, VA San Diego Healthcare System, San Diego, CA, United States.
Vicente ArroyoLiver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques Agust Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.
Centre de Recherche sur l'Inflammation · FRCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas · ESPoliclinico S.Orsola-Malpighi · ITUniversity of California, San Diego · USUniversity of Padua · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The peripheral arterial vasodilation hypothesis has been most influential in the field of cirrhosis and its complications. It has given rise to hundreds of pathophysiological studies in experimental and human cirrhosis and is the theoretical basis of life-saving treatments. It is undisputed that splanchnic arterial vasodilation contributes to portal hypertension and is the basis for manifestations such as ascites and hepatorenal syndrome, but the body of research generated by the hypothesis has revealed gaps in the original pathophysiological interpretation of these complications. The expansion of our knowledge on the mechanisms regulating vascular tone, inflammation and the host-microbiota interaction require a broader approach to advanced cirrhosis encompassing the whole spectrum of its manifestations. Indeed, multiorgan dysfunction and failure likely result from a complex interplay where the systemic spread of bacterial products represents the primary event. The consequent activation of the host innate immune response triggers endothelial molecular mechanisms responsible for arterial vasodilation, and also jeopardizes organ integrity with a storm of pro-inflammatory cytokines and reactive oxygen and nitrogen species. Thus, the picture of advanced cirrhosis could be seen as the result of an inflammatory syndrome in contradiction with a simple hemodynamic disturbance.

Indexed as

InflammationLiver FailureAnimalsArteriesCytokinesHumansLiver CirrhosisVasodilationCytokinesAscitesBacterial translocationCardiovascular dysfunctionCirrhosisPeripheral arterial vasodilation hypothesisPro-inflammatory cytokinesRenal dysfunctionSystemic inflammation

Identifiers

PMID26192220
OpenAlexW2144416322

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.