Review
Medicine, General & Internal
Young-Kook Kim, Juhyun Song
Summary: Hepatic encephalopathy is a common complication in patients with liver cirrhosis, involving various pathogeneses such as ammonia-induced oxidative stress and neuronal cell death. Researchers are exploring the effects of resveratrol on neuropathogenesis and the gut-liver axis to potentially improve the treatment of hepatic encephalopathy.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Biochemistry & Molecular Biology
Lucia Giuli, Marta Maestri, Francesco Santopaolo, Maurizio Pompili, Francesca Romana Ponziani
Summary: Acute liver failure and chronic liver disease are associated with neurological changes, with hepatic encephalopathy being the most well-known. Recent studies have shown that neuroinflammation plays a key role in the development of neurological complications in this setting. Dysbiosis and altered intestinal permeability resulting from liver disease can lead to bacterial translocation and endotoxemia, causing systemic inflammation and triggering neuroinflammation.
Article
Gastroenterology & Hepatology
Bryan D. Badal, Jasmohan S. Bajaj
Summary: The inclusion of acute encephalopathy in all society definitions of acute-on-chronic liver failure (ACLF) highlights its significance in the syndrome. Acute encephalopathy in ACLF is caused by severe inflammation, and it is important to identify reversible causes. Hepatic encephalopathy not only increases mortality in ACLF but also hinders evaluation for liver transplant due to patient instability. Further research is needed to identify at-risk individuals, develop better prognostic tools, and explore novel treatments. Optimal ICU care, palliative care services, and patient satisfaction should be considered in managing encephalopathic patients.
CLINICS IN LIVER DISEASE
(2023)
Article
Gastroenterology & Hepatology
Viniyendra Pamecha, Nilesh Sadashiv Patil, Sanyam Falari, Nihar Mohapatra, Anubhav Harshit Kumar, Gaurav Sindwani, Neha Garg, Seema Alam, Rajeev Khanna, Vikrant Sood, Bikrant Bihari Lal
Summary: This study aimed to investigate the challenges and outcomes of live-donor liver transplantation (LDLT) for pediatric acute liver failure (PALF). A total of 315 patients with PALF were treated over 11 years, and 42 underwent liver transplantation. The outcomes of LDLT for PALF were analyzed.
HEPATOLOGY INTERNATIONAL
(2023)
Review
Immunology
Zefeng Chen, Jingsheng Ruan, Dinghua Li, Min Wang, Zhiwei Han, Wenxia Qiu, Guobin Wu
Summary: Hepatic encephalopathy is a neurological disorder that occurs in patients with liver insufficiency, and its pathogenesis has not been fully elucidated. Pharmacotherapy is the main therapeutic option for HE, which targets the pathogenesis of HE by reducing ammonia levels, improving neurotransmitter signal transduction, and modulating intestinal microbiota. The intestinal microbiota is closely associated with multiple links in the pathogenesis of HE, and restoring the homeostasis of intestinal bacteria or providing specific probiotics has significant effects on neurological disorders in HE.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2021)
Article
Medicine, General & Internal
Liyuan Long, Hai Li, Guohong Deng, Xianbo Wang, Sihong Lu, Beiling Li, Zhongji Meng, Yanhang Gao, Zhiping Qian, Feng Liu, Xiaobo Lu, Haotang Ren, Jia Shang, Hai Li, Shaoyang Wang, Yubao Zheng, Huadong Yan, Shan Yin, Wenting Tan, Qun Zhang, Xin Zheng, Jinjun Chen, Sen Luo, Jinming Zhao, Wei Yuan, Tao Li, Rongjiong Zheng, Junping Liu, Xiaoxiao Liu, Wenyi Gu, Sumeng Li, Xue Mei, Ruochan Chen, Yan Huang
Summary: Hepatic encephalopathy has a significant impact on adverse outcomes in patients with acute-on-chronic liver diseases, especially in those with grades 3-4 hepatic encephalopathy. Patients with alcohol consumption are more likely to develop hepatic encephalopathy compared to those with hepatitis B virus infection, and the impact of different grades of hepatic encephalopathy on adverse outcomes increases progressively.
FRONTIERS IN MEDICINE
(2021)
Article
Cell Biology
Ali Sepehrinezhad, Ali Shahbazi, Mohammad Taghi Joghataei, Fin Stolze Larsen, Sajad Sahab Negah
Summary: There is growing evidence that the levels of autotaxin (ATX) and lysophosphatidic acid (LPA) in the circulatory system are increased in patients with severe liver disease. However, the role of the ATX-LPA axis in hepatic encephalopathy (HE) is still unclear. This study aimed to investigate the role of the ATX-LPA signaling pathway in mice with thioacetamide (TAA)-induced acute HE.
CELL DEATH & DISEASE
(2023)
Review
Gastroenterology & Hepatology
William Bernal, Constantine Karvellas, Faouzi Saliba, Fuat H. Saner, Philippe Meersseman
Summary: Acute-on-chronic liver failure syndrome involves liver function deterioration, extrahepatic organ failure, and high mortality rate, requiring rapid and coherent management in the intensive care unit to improve patient outcomes.
JOURNAL OF HEPATOLOGY
(2021)
Review
Gastroenterology & Hepatology
Fin S. Larsen, Faouzi Saliba
Summary: Acute liver failure (ALF) leads to numerous complications, resulting in multi-organ failure. This review focuses on the pathophysiological processes and management strategies using artificial liver support and liver transplantation (LT). The deterioration in ALF is caused by hyperammonemia and release of DAMPs, leading to hepatic encephalopathy, cerebral edema, and inflammatory activation. Continuous renal replacement therapy (CRRT) and plasma exchange are effective in removing ammonia and DAMPs. LT criteria for non-paracetamol cases are robust, but criteria for paracetamol-intoxicated patients are more unreliable. Post-LT survival rates have significantly improved, reaching 90% for patients needing LT for survival.
LIVER INTERNATIONAL
(2023)
Article
Biochemistry & Molecular Biology
Kazuhiko Nakadate, Sumito Kamata
Summary: This study investigated the pathological changes associated with acute hepatic encephalopathy in a mouse model. The results showed that ammonium acetate treatment caused enlargement of the lateral ventricles and swelling of the choroid plexus. Additionally, there were changes in the localization of aquaporin-1 after treatment.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Review
Biochemistry & Molecular Biology
So Yeong Cheon, Juhyun Song
Summary: Hepatic encephalopathy and diabetic encephalopathy are emerging types of neurological diseases characterized by cognitive and motor impairments. The relationship between metabolic organs and the brain plays an important role in the pathogenesis of neurological diseases.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Review
Gastroenterology & Hepatology
Wouter Claeys, Lien Van Hoecke, Sander Lefere, Anja Geerts, Xavier Verhelst, Hans Van Vlierberghe, Helena Degroote, Lindsey Devisscher, Roosmarijn E. Vandenbroucke, Christophe Van Steenkiste
Summary: Hepatic encephalopathy (HE) is a neurological complication of liver dysfunction and portosystemic shunting, highly prevalent in cirrhosis patients and associated with poor outcomes. New insights into peripheral origins in HE have led to innovative treatments like fecal microbiota transplantation, but central nervous system perturbations have not been fully considered. This review proposes a holistic approach, describing HE as a global dysfunction of the neurogliovascular unit, impacting blood flow, nutrient supply, blood-brain barrier function, and leading to accumulation of neurotoxic substances. Taking a broader view of central nervous system alterations in liver disease could aid in further research into HE pathophysiology and development of specific therapeutic strategies targeting central nervous system damage.
Article
Gastroenterology & Hepatology
Rajiv Jalan, Christopher F. Rose
Summary: The clinical progress in managing hepatic encephalopathy lags behind basic research, making current criteria for definition, classification, diagnosis, and grading difficult to apply reproducibly. Studies suggest that hepatic encephalopathy may be irreversible in many patients, requiring further research into neuronal injury and death mechanisms for future drug development. Lactulose, currently considered the standard of care, has poor clinical evidence for all severity levels of hepatic encephalopathy, and ethical consideration should be given to placebo-controlled trials.
JOURNAL OF HEPATOLOGY
(2022)
Article
Medicine, Research & Experimental
Jun Weng, Xu Han, Fanhong Zeng, Yue Zhang, Lei Feng, Lei Cai, Kangyan Liang, Shusong Liu, Shao Li, Gongbo Fu, Min Zeng, Yi Gao
Summary: The study utilized a fiber scaffold bioreactor for high-density, 3D culture of porcine hepatocytes to construct a bioartificial liver and evaluated its protective effects in an ALF porcine model. The bioartificial liver treatment enhanced liver regeneration, alleviated systemic inflammatory response, and reduced extrahepatic organ injury, leading to prolonged survival in the ALF model.
Article
Biochemistry & Molecular Biology
Subhasis Roy, Monali Chakrabarti, Hemantika Dasgupta, Ashutosh Mahale, Shraddha Tripathi, Vivek Sharma, Manish Banerjee, Onkar Prakash Kulkarni
Summary: Growing evidence suggests that autotaxin-lysophosphatidic acid (LPA) signaling plays an important role in the pathogenesis of hepatic encephalopathy (HE). Inhibiting autotaxin can attenuate neuroinflammation and improve neurological dysfunction in a mouse model of HE. Furthermore, HE mice display increased neuroinflammation and LPA levels, which can be significantly improved by ATXi treatment.
ACS CHEMICAL NEUROSCIENCE
(2022)
Article
Gastroenterology & Hepatology
Rita Garcia-Martinez, Fausto Andreola, Gautam Mehta, Katie Poulton, Marc Oria, Maria Jover, Junpei Soeda, Jane Macnaughtan, Francesco De Chiara, Abeba Habtesion, Rajeshwar P. Mookerjee, Nathan Davies, Rajiv Jalan
JOURNAL OF HEPATOLOGY
(2015)
Article
Gastroenterology & Hepatology
Fernando Diaz-Fontenla, Marta Castillo-Pradillo, Arantxa Diaz-Gomez, Luis Ibanez-Samaniego, Pilar Gancedo, Juan Adan Guzman-de-Villoria, Pilar Fernandez-Garcia, Rafael Banares-Canizares, Rita Garcia-Martinez
WORLD JOURNAL OF GASTROENTEROLOGY
(2017)
Article
Gastroenterology & Hepatology
Macarena Simon-Talero, Davide Roccarina, Javier Martinez, Katharina Lampichler, Anna Baiges, Gavin Low, Elba Llop, Michael Praktiknjo, Martin H. Maurer, Alexander Zipprich, Michela Triolo, Guillaume Vangrinsven, Rita Garcia-Martinez, Annette Dam, Avik Majumdar, Carmen Picon, Daniel Toth, Anna Darnell, Juan G. Abraldes, Marta Lopez, Guido Kukuk, Aleksander Krag, Rafael Banares, Wim Laleman, Vincenzo La Mura, Cristina Ripoll, Annalisa Berzigotti, Jonel Trebicka, Jose Luis Calleja, Puneeta Tandon, Virginia Hernandez-Gea, Thomas Reiberger, Agustin Albillos, Emmanuel A. Tsochatzis, Salvador Augustin, Joan Genesca
Article
Gastroenterology & Hepatology
Elsa Sola, Cristina Sole, Macarena Simon-Talero, Marta Martin-Llahi, Jose Castellote, Rita Garcia-Martinez, Rebeca Moreira, Maria Torrens, Francisca Marquez, Nuria Fabrellas, Gloria de Prada, Patricia Huelin, Eva Lopez Benaiges, Meritxell Ventura, Marcela Manriquez, Andre Nazar, Xavier Ariza, Pilar Sune, Isabel Graupera, Elisa Pose, Jordi Colmenero, Marco Pavesi, Monica Guevara, Miquel Navasa, Xavier Xiol, Joan Cordoba, Victor Vargas, Pere Gines
JOURNAL OF HEPATOLOGY
(2018)
Article
Gastroenterology & Hepatology
Jonel Trebicka, Javier Fernandez, Maria Papp, Paolo Caraceni, Wim Laleman, Carmine Gambino, Ilaria Giovo, Frank Erhard Uschner, Cesar Jimenez, Rajeshwar Mookerjee, Thierry Gustot, Agustin Albillos, Rafael Banares, Martin Janicko, Christian Steib, Thomas Reiberger, Juan Acevedo, Pietro Gatti, William Bernal, Stefan Zeuzem, Alexander Zipprich, Salvatore Piano, Thomas Berg, Tony Bruns, Flemming Bendtsen, Minneke Coenraad, Manuela Merli, Rudolf Stauber, Heinz Zoller, Jose Presa Ramos, Cristina Sole, German Soriano, Andrea de Gottardi, Henning Gronbaek, Faouzi Saliba, Christian Trautwein, Osman Cavit Ozdogan, Sven Francque, Stephen Ryder, Pierre Nahon, Manuel Romero-Gomez, Hans Van Vlierberghe, Claire Francoz, Michael Manns, Elisabet Garcia, Manuel Tufoni, Alex Amoros, Marco Pavesi, Cristina Sanchez, Anna Curto, Carla Pitarch, Antonella Putignano, Esau Moreno, Debbie Shawcross, Ferran Aguilar, Joan Claria, Paola Ponzo, Christian Jansen, Zsuzsanna Vitalis, Giacomo Zaccherini, Boglarka Balogh, Victor Vargas, Sara Montagnese, Carlo Alessandria, Mauro Bernardi, Pere Gines, Rajiv Jalan, Richard Moreau, Paolo Angeli, Vicente Arroyo
JOURNAL OF HEPATOLOGY
(2020)
Article
Critical Care Medicine
Francois-Xavier Lescure, Hitoshi Honda, Robert A. Fowler, Jennifer Sloane Lazar, Genming Shi, Peter Wung, Naimish Patel, Owen Hagino
Summary: This study aimed to evaluate the safety and efficacy of sarilumab in patients with severe or critical COVID-19, but found no significant efficacy in patients admitted to the hospital receiving supplemental oxygen. Future adequately powered trials of targeted immunomodulatory therapies with survival as a primary endpoint are suggested for patients with critical COVID-19.
LANCET RESPIRATORY MEDICINE
(2021)
Article
Gastroenterology & Hepatology
Jonel Trebicka, Javier Fernandez, Maria Papp, Paolo Caraceni, Wim Laleman, Carmine Gambino, Ilaria Giovo, Frank Erhard Uschner, Christian Jansen, Cesar Jimenez, Rajeshwar Mookerjee, Thierry Gustot, Agustin Albillos, Rafael Banares, Peter Jarcuska, Christian Steib, Thomas Reiberger, Juan Acevedo, Pietro Gatti, Debbie L. Shawcross, Stefan Zeuzem, Alexander Zipprich, Salvatore Piano, Thomas Berg, Tony Bruns, Karen Vagner Danielsen, Minneke Coenraad, Manuela Merli, Rudolf Stauber, Heinz Zoller, Jose Presa Ramos, Cristina Sole, German Soriano, Andrea de Gottardi, Henning Gronbaek, Faouzi Saliba, Christian Trautwein, Haluk Tarik Kani, Sven Francque, Stephen Ryder, Pierre Nahon, Manuel Romero-Gomez, Hans Van Vlierberghe, Claire Francoz, Michael Manns, Elisabet Garcia-Lopez, Manuel Tufoni, Alex Amoros, Marco Pavesi, Cristina Sanchez, Michael Praktiknjo, Anna Curto, Carla Pitarch, Antonella Putignano, Esau Moreno, William Bernal, Ferran Aguilar, Joan Claria, Paola Ponzo, Zsuzsanna Vitalis, Giacomo Zaccherini, Boglarka Balogh, Alexander Gerbes, Victor Vargas, Carlo Alessandria, Mauro Bernardi, Pere Gines, Richard Moreau, Paolo Angeli, Rajiv Jalan, Vicente Arroyo, Miriam Maschmeier, David Semela, Laure Elkrief, Ahmed Elsharkawy, Tamas Tornai, Istvan Tornai, Istvan Altorjay, Agnese Antognoli, Maurizio Baldassarre, Martina Gagliardi, Eleonora Bertoli, Sara Mareso, Alessandra Brocca, Daniela Campion, Giorgio Maria Saracco, Martina Rizzo, Jennifer Lehmann, Alessandra Pohlmann, Maximilian J. Brol, Johannes Chang, Robert Schierwagen, Elsa Sola, Nesrine Amari, Miguel Rodriguez, Frederik Nevens, Ana Clemente, Martin Janicko, Daniel Markwardt, Mattias Mandorfer, Christoph Welsch, Tanja M. Welzel, Emanuela Ciraci, Vish Patel, Cristina Ripoll, Adam Herber, Paul Horn, Flemming Bendtsen, Lise Lotte Gluud, Jelte Schaapman, Oliviero Riggio, Florian Rainer, Joerg Tobiasch Moritz, Monica Mesquita, Edilmar Alvarado-Tapias, Osagie Akpata, Luise Aamann, Didier Samuel, Sylvie Tresson, Pavel Strnad, Roland Amathieu, Macarena Simon-Talero, Francois Smits, Natalie van den Ende, Javier Martinez, Rita Garcia, Harald Rupprechter, Cornelius Engelmann, Osman Cavit Ozdogan
Summary: This study analyzed the precipitants leading to acute decompensation in cirrhosis patients, identifying proven bacterial infections and severe alcoholic hepatitis as the main causes. The number of precipitants was significantly associated with 90-day mortality, emphasizing the need for specific preventive and therapeutic strategies targeting these events.
JOURNAL OF HEPATOLOGY
(2021)
Article
Biochemistry & Molecular Biology
Laura Perez-Lago, Teresa Aldamiz-Echevarria, Rita Garcia-Martinez, Leire Perez-Latorre, Marta Herranz, Pedro Sola-Campoy, Julia Suarez-Gonzalez, Carolina Martinez-Laperche, Inaki Comas, Fernando Gonzalez-Candelas, Pilar Catalan, Patricia Munoz, Dario Garcia de Viedma
Summary: This study investigates the clinical profiles of severely immunosuppressed patients with prolonged shedding of SARS-CoV-2, revealing acquired viral diversity and different evolutionary dynamics within patients.
Article
Gastroenterology & Hepatology
Erica Lafoz, Genis Camprecios, Hector Garcia-Caldero, Aina Anton, Marina Vilaseca, Maria Ruart, Eduard Guasch, Gloria Garrabou, Teresa C. Delgado, Maria-Luz Martinez-Chantar, Rita Garcia-Martinez, Jordi Gracia-Sancho, Virginia Hernandez-Gea, Juan Carlos Garcia-Pagan
Summary: This study developed two advanced cirrhosis regression experimental models with persistent fibrosis and portal hypertension, mimicking patient conditions. Despite improving metabolism, lifestyle interventions did not enhance the regression process in cirrhotic models. Caloric restriction did not further reduce portal pressure, hepatic fibrosis, or HSC activation. Moderate endurance exercise exhibited a profibrogenic effect in the liver, blunting cirrhosis regression. Potential ammonia accumulation could be one explanation for this worsened effect.
AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY
(2021)
Article
Clinical Neurology
Luis Ibanez-Samaniego, Marta Rapado-Castro, Lucia Cabrero, Cristina Navarrete, Seila Garcia-Mulas, Adriana Ahumada, Laura Marquez, Maria Dolores Perez, Diego Rincon, Rafael Banares, Rita Garcia-Martinez
Summary: Hepatitis C virus (HCV) infection is associated with neuropsychiatric disturbances that impact functioning and health-related quality of life. This study found that eradication of HCV can decrease cognitive impairment prevalence and improve functioning and HRQoL, with older patients and those with baseline cognitive impairment benefitting the most. Persistent cognitive impairment may be associated with factors like higher cardiovascular risk, cirrhosis, lower education, and higher anxiety and depression scores.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Review
Pharmacology & Pharmacy
Rita Garcia-Martinez, Raquel Diaz-Ruiz, Marta Poncela
Summary: Hepatic encephalopathy (HE) is a common and recurrent condition in patients with advanced liver disease. Its pathophysiology involves hyperammonaemia and inflammation. There are currently no specific diagnostic tests, and diagnosis is based on clinical symptoms, presence of predisposing liver condition, and exclusion of other causes. Treatment aims to reduce the duration and intensity of episodes, prevent recurrence, and minimize the impact on patients and their relatives.
CLINICAL DRUG INVESTIGATION
(2022)
Article
Gastroenterology & Hepatology
Mario Romero-Cristobal, Ana Clemente-Sanchez, Maria-Isabel Peligros, Enrique Ramon, Ana-Maria Matilla, Arturo Colon, Sonia Alonso, Maria-Vega Catalina, Ainhoa Fernandez-Yunquera, Aranzazu Caballero, Rita Garcia, Jose Angel Lopez-Baena, Maria-Magdalena Salcedo, Rafael Banares, Diego Rincon
Summary: This study evaluated the relationship between volumetric changes assessed by multidetector computerised tomography (MDCT) and landmark features of cirrhosis. The results showed that liver and spleen volumetric indices evolve differently along the natural history of cirrhosis and are associated with key prognostic factors in each phase.
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
(2022)
Article
Microbiology
Maria Jesus Perez-Granda, Pilar Catalan, Patricia Munoz, Teresa Aldamiz, Juan Camilo Barrios, Carlos Ramirez, Rita Garcia-Martinez, Maria Victoria Villalba, Luis Puente, Emilio Bouza
Summary: The purpose of this study was to determine the prevalence of CMV reactivation in severe COVID-19 patients admitted to a general hospital. The study included 140 hospitalized COVID-19 patients, with 16 patients (11.42%) testing positive for CMV-DNA in their blood. The ICU patients had a higher prevalence of CMV reactivation compared to patients in the general wards, and had a worse prognosis due to a higher cumulative dose of corticosteroids.
REVISTA ESPANOLA DE QUIMIOTERAPIA
(2023)
Article
Gastroenterology & Hepatology
Mario Romero-Cristobal, Ana Clemente-Sanchez, Patricia Pineiro, Jamil Cedeno, Laura Rayon, Julia del Rio, Clara Ramos, Diego-Andres Hernandez, Miguel Cova, Aranzazu Caballero, Ignacio Garutti, Pablo Garcia-Olivares, Javier Hortal, Jose-Eugenio Guerrero, Rita Garcia, Rafael Banares, Diego Rincon
Summary: This study found that unrecognized liver fibrosis, assessed by serological tests prior to admission, is independently associated with a higher risk of death in patients with severe COVID-19 admitted to the ICU.
THERAPEUTIC ADVANCES IN GASTROENTEROLOGY
(2021)
Article
Immunology
Jonel Trebicka, Alex Amoros, Carla Pitarch, Esther Titos, Jose Alcaraz-Quiles, Robert Schierwagen, Carmen Deulofeu, Javier Fernandez-Gomez, Salvatore Piano, Paolo Caraceni, Karl Oettl, Elsa Sola, Wim Laleman, Jane McNaughtan, Rajeshwar P. Mookerjee, Minneke J. Coenraad, Tania Welzel, Christian Steib, Rita Garcia, Thierry Gustot, Miguel A. Rodriguez Gandia, Rafael Banares, Agustin Albillos, Stefan Zeuzem, Victor Vargas, Faouzi Saliba, Frederic Nevens, Carlo Alessandria, Andrea de Gottardi, Heinz Zoller, Pere Gines, Tilman Sauerbruch, Alexander Gerbes, Rudolf E. Stauber, Mauro Bernardi, Paolo Angeli, Marco Pavesi, Richard Moreau, Joan Claria, Rajiv Jalan, Vicente Arroyo
FRONTIERS IN IMMUNOLOGY
(2019)