The pathophysiology of NASH remains incompletely understood. Recent data point towards an important role for changes, both functional and structural, in liver vasculature as an early event in NASH development. Also at later stages, vascular alterations appear to play a role. Data suggest that portal hypertension in NASH might be different from portal hypertension in alcohol or virus-related cirrhosis.
Sven M. Francque explores how these findings not only have an impact on daily clinical care and follow-up, but are also particularly relevant for the pharmacological treatment of NASH cirrhosis, both in terms of the choice of drugs and the design of the trials.