Are angiotensins involved in the haemodynamic changes of cirrhosis patients?
Liver cirrhosis has been recently studied in the light of the new view of the renin angiotensin system (RAS). While the angiotensin converting enzyme (ACE)-Ang 2-AT1 receptor arm contributes to liver tissue injury and fibrosis and the maintenance of basal vascular tonus in non-compensated cirrhosis, the activation of the ACE2-Ang-(1-7)-Mas receptor arm exerts anti-fibrotic actions and probably has also a role in arterial vasodilation in liver cirrhosis. In a previous study published last year in WJG by the same research group, it was shown that chronic treatment with propranolol in cirrhotic patients was characterised by marked changes in the precursors of the RAS cascade (renin and Ang 1 with repercussions on the 2 main RAS components, Ang 2 and Ang-(1-7), in the splanchnic and peripheral circulation. Therefore, the circulating profile of RAS components at different stages of liver cirrhosis and their role in haemodynamic changes of cirrhosis remained unclear...