Features of redox homeostasis in patients with liver cirrhosis (literature review and clinical case description)

Abstract

Aim. To review the literature devoted to the study of redox homeostasis in patients with liver cirrhosis, and to describe the clinical case from practice. Material and Methods. The content analysis, method of systematic and comparative analysis, and bibliosemantic method of studying relevant research concerning the state of redox homeostasis in patients with liver cirrhosis were used. The data was searched in the following research databases: PubMed, Medline, Springer, Google Scholar, Research Gate by keywords: liver cirrhosis, redox homeostasis, endothelial dysfunction, oxidative stress, antioxidants, portal hypertension. As many as 143 English and Ukrainian sources were analyzed. The sources highlighting the features of redox homeostasis in patients with liver cirrhosis were selected. A clinical case is described. Results and Discussion. The review of the current literature and the description of the clinical case suggest that under the influence of alcohol, hepatitis B and C, medicines, etc., an imbalance occurs in the system of prooxidants-antioxidants, causing multiple molecular and biochemical changes in the liver and nervous system due to changes in L-arginine, nitric oxide, endothelin metabolism, as well as synthesis, activation, and deactivation of cytokines, lipid peroxidation products, adhesion molecules, pro-, anticoagulation factors, and immune complexes, which increases the disease severity. The revealed role of oxidative stress, in turn, urges us to use medicines with antioxidant properties for treatment of patients with liver cirrhosis. Conclusions. Under the influence of a number of etiologic factors of the liver cirrhosis onset, there is the disturbance of redox homeostasis, which causes endothelial dysfunction and leads to an imbalance of the autonomic nervous system and increases the disease severity, which causes us to use medicines with antioxidant properties in the treatment.

Keywords

• cirrhosis, endothelial dysfunction, oxidative stress, antioxidants, portal hypertension