{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:44:15Z","timestamp":1792197855077,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Etiopathogenesis of porto\u2010sinusoidal vascular disorder (PSVD) is poorly known. The present study aimed to investigate alterations in gut barrier, bacterial translocation, and pro\u2010aggregating\/pro\u2010coagulant state and their relationship with liver injury in patients with PSVD without portal hypertension (PH\u2212) in comparison with PSVD with PH (PH+) and healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>34 patients with PSVD (17 PH+ and 17 PH\u2212) and 17 healthy subjects were submitted to measurement of zonulin and lipopolysaccharides (LPS), markers of intestinal permeability, of s\u2010Glycoprotein VI, sP\u2010selectin, ADAMTS13 and von Willebrand factor (vWF), markers of platelet aggregation and vascular dysfunction, factor VIII and F1\u2009+\u20092, markers of hypercoagulability. In 30 PSVD patients, a histomorphological\/immunohistochemical study on liver biopsies was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PSVD PH\u2212 patients had higher serum levels of LPS, zonulin, vWF, factor VIII, sP\u2010selectin, F1\u2009+\u20092 and lower levels of ADAMTS13 compared to healthy controls. These alterations were even more pronounced in PSVD PH+. At histological analysis, compared to those of healthy subjects, livers of patients with PSVD PH\u2212 showed a higher number of TLR4+ macrophages and of platelets within sinusoids with signs of aggregation. Perivascular fibrosis and sinusoid capillarisation were higher too. PSVD PH\u2212 had a lower degree of obliterative portal venopathy and portal inflammation compared to patients PH+.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Even before the development of PH, patients with PSVD exhibit increased intestinal permeability and bacterial translocation, related platelet aggregation, and hypercoagulability, suggesting that endotoxemia may play a pivotal role in the pathogenesis of vascular alterations underlying PSVD. Moreover, this study indicates that PSVD without and with PH represent different stages of the same disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70277","type":"journal-article","created":{"date-parts":[[2025,8,9]],"date-time":"2025-08-09T06:04:16Z","timestamp":1754719456000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Role of Gut\u2010Derived Endotoxins in Porto\u2010Sinusoidal Vascular Disorder: Comparison Between patients with and without portal hypertension"],"prefix":"10.1111","volume":"45","author":[{"given":"Diletta","family":"Overi","sequence":"first","affiliation":[{"name":"Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine and Hepatology, Department of Gastroenterology IRCCS Humanitas Research Hospital  Rozzano Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Pieve Emanuele Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6216-9595","authenticated-orcid":false,"given":"Roberto","family":"Carnevale","sequence":"additional","affiliation":[{"name":"Department of Medical\u2010Surgical Sciences and Biotechnologies Sapienza University of Rome  Latina Italy"},{"name":"IRCCS Neuromed  Pozzilli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Nardelli","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Tavano","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine Sapienza University of Rome  Rome 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