Attieh P, Karam K, Farhat SG. Letter to the Editor: Activation of lymphangiogenesis by platelets as a novel therapeutic approach for liver cirrhosis and portal hypertension. World J Hepatol 2026; 18(10): 118131 [DOI: 10.4254/wjh.118131]
Corresponding Author of This Article
Said G Farhat, MD, Department of Hepatology and Gastroenterology, University of Balamand, Ashrafiye, Beirut 1003, Lebanon. saidfarhat@hotmail.com
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Gastroenterology & Hepatology
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letter
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Attieh P, Karam K, Farhat SG. Letter to the Editor: Activation of lymphangiogenesis by platelets as a novel therapeutic approach for liver cirrhosis and portal hypertension. World J Hepatol 2026; 18(10): 118131 [DOI: 10.4254/wjh.118131]
World J Hepatol. Oct 27, 2026; 18(10): 118131 Published online Oct 27, 2026. doi: 10.4254/wjh.118131
Letter to the Editor: Activation of lymphangiogenesis by platelets as a novel therapeutic approach for liver cirrhosis and portal hypertension
Philippe Attieh, Karam Karam, Said G Farhat
Philippe Attieh, Department of General Surgery, University of Balamand, Beirut 1003, Lebanon
Karam Karam, Said G Farhat, Department of Hepatology and Gastroenterology, University of Balamand, Beirut 1003, Lebanon
Co-first authors: Philippe Attieh and Karam Karam.
Author contributions: Attieh P and Karam K contributed equally to this article, they are the co-first authors of this manuscript; Attieh P, Karam K, and Farhat SG conceptualized the study, drafted the original manuscript, and performed the review and editing of the subsequent versions; Farhat SG supervised the project and was responsible for its administration; and all authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Said G Farhat, MD, Department of Hepatology and Gastroenterology, University of Balamand, Ashrafiye, Beirut 1003, Lebanon. saidfarhat@hotmail.com
Received: December 24, 2025 Revised: January 23, 2026 Accepted: March 2, 2026 Published online: October 27, 2026 Processing time: 294 Days and 7 Hours
Abstract
This article offers commentary on a recent article published by Chen et al the connection between lymphangiogenesis and platelet activity - specifically, how platelets adhere, aggregate, and become activated - in a rat model of liver cirrhosis induced by bile duct ligation. Using both gain- and loss-of-function strategies, the researchers either stimulated angiogenic pathways with platelet-rich plasma or inhibited them with the vascular endothelial growth factor receptor 3 inhibitor MAZ-51. Their findings highlight the significant role that lymphangiogenesis plays in the progression of liver cirrhosis and the development of portal hypertension. Clinically, platelet transfusion has already been used to support liver function in patients with chronic liver disease and cirrhosis. Therefore, this study strengthens the rationale for using platelet therapy or targeting lymphangiogenesis pharmacologically as potential novel treatments for cirrhosis and portal hypertension.
Core Tip: Despite encouraging findings, our understanding of how platelet transfusion enhances liver function in patients with chronic liver disease and cirrhosis remains incomplete. Unraveling the precise biological mechanisms involved could open new avenues for translating these observations into clinical practice. Moreover, to bring platelet-rich plasma-based therapies closer to routine care, clinical studies are needed to assess their safety in patients with cirrhosis. Standardizing platelet-rich plasma preparation methods and closely monitoring for potential complications, such as the risk of portal vein thrombosis, will also be essential to ensure consistent and safe clinical outcomes.
