HYPOXIA-INDUCIBLE FACTOR AS A MOLECULAR TARGET IN HEPATORENAL SYNDROME

Hepatorenal syndrome (HRS) is a serious complication of alcohol liver cirrhosis (ALC). Studying of the mechanisms of molecular response to hypoxia in HRS is a promising direction of research in hepatology. The aim of present study was to evaluate the role of hypoxia-inducible factor HIF-1 alpha in the pathogenesis of HRS at the acute-on-chronic (ACLF) liver failure (CLF) in patients with ALC. 150 patients with ALC+ HRS were divided into 2 groups: I group (n= 67) -CLF,II group(n= 83) - ACLF. Level of HIF-1 alpha in the most severe category of patients in group 2, with stage IV by CLIF-C-ACLF scale, was almost three times higher than that of a similar category in group 1, with Child-Pugh C class, and was 30 +/- 7,9 ng/ml. Dramatic increase of HIF-1a level in the group 2 patients with the IV stage by CLIF-C-ACLF scale confirms the severe tissue hypoxia, which is caused by a significant deterioration of the splanchnic blood flow and spasm of renal vessels at the HRS. HIF-1 alpha levels closely correlate with the indicators of hepatic and renal failure in the patients with ALC+HRS, which allows to use it as an indicator for comprehensive diagnosis of this disease.