HARTL Lukas

Humoral and Endocrine Abnormalities in Patients with Advanced Chronic Liver Disease

Dysbalance of hormonal homeostasis is critically involved in development and progression of portal hypertension (PH) and may also influence liver fibrosis. While many studies have investigated the levels of different hormones in patients with advanced chronic liver disease (ACLD), there have not yet been more comprehensive studies, investigating patterns of hormonal dysregulation in different stages of PH and ACLD.

The goal of this project is to thoroughly investigate the dysregulation of hormonal systems in patients with ACLD, including cardiovascular hormones like classical and non-classical pathways of the reninangiotensin-aldosterone-system (RAAS), brain-type natriuretic peptide (BNP) and arginine-vasopressin (AVP), as well as the hypothalamic-pituitary-adrenal (HPA) axis. The three independent aims of this project include the characterization of (i) vasoactive hormones in distinct stages of portal hypertension (PH), (ii) activation patterns of the classical and non-classical RAAS in different stages of ACLD and (iii) the hypothalamic-pituitary-adrenal (HPA) axis across ACLD stages.

This way, a comprehensive fingerprint of the hormonal status in different stages of ACLD and PH will be generated, in order to assess the critical role of humoral and endocrine dysregulations in liver cirrhosis. Importantly, hepatic venous pressure gradient (HVPG) will be measured in all patients that ensuring a comprehensive and reliable characterization of the severity of portal hypertension at the time of hormone level assessment.

Methods and Skills:

clinical studies; animal experiments

Publications:

Hartl L, Jachs M, Desbalmes C, Schaufler D, Simbrunner B, Paternostro R, Schwabl P, Bauer DJM, Semmler G, Scheiner B, Bucsics T, Eigenbauer E, Marculescu R, Szekeres T, Peck-Radosavljevic M, Kastl S, Trauner M, Mandorfer M, Reiberger T. The differential activation of cardiovascular hormones across distinct stages of portal hypertension predicts clinical outcomes. Hepatol Int 15: 1160-1173, 2021

Hartl L, Semmler G, Hofer BS, Schirwani N, Jachs M, Simbrunner B, Bauer DJM, Binter T, Pomej K, Pinter M, Trauner M, Mandorfer M, Reiberger T, Scheiner B. COVID-19-related downscaling of in-hospital liver care decreased patient satisfaction and increased liver-related mortality. Hepatol Commun 5: 1660-1675, 2021

Hartl L, Elias J, Prager G, Reiberger T, Unger LW. Individualized treatment options for patients with non-cirrhotic and cirrhotic liver disease. World J Gastroenterol 27: 2281-2298, 2021