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
Biochemistry & Molecular Biology
Rafael Ochoa-Sanchez, Farzaneh Tamnanloo, Christopher F. Rose
Summary: Hepatic encephalopathy (HE) is a neuropsychiatric syndrome associated with liver disease, reversible in theory but leading to persistent neurological complications in some patients post-liver transplantation. These enduring complications impact quality of life and healthcare costs, highlighting the need for further understanding of the underlying mechanisms.
NEUROCHEMICAL RESEARCH
(2021)
Article
Biochemical Research Methods
Alina Schrimpf, Olivia Knappe, Natalia Qvartskhava, Gereon Poschmann, Kai Stuehler, Hans Jurgen Bidmon, Tom Luedde, Dieter Haeussinger, Boris Goerg
Summary: This study investigates the molecular alterations in the brain associated with cerebral impairment in hyperammonemic disorders. Through transcriptomics and proteomics analysis, the researchers identified genes and proteins whose expressions were altered in a brain region-specific way in the brains of mice with systemic hyperammonemia. Further analyses of selected candidates revealed their roles in oxidative stress, cell proliferation, heme metabolism, senescence, RNA quality control, and disturbed iron homeostasis, suggesting their potential relevance in cerebral dysfunction in hyperammonemic disorders.
ANALYTICAL BIOCHEMISTRY
(2022)
Article
Environmental Sciences
Ahmed A. Sedik, Azza Hassan, Dalia O. Saleh
Summary: The aim of this study was to investigate the impact of arginine (ARG) on thioacetamide (TAA)-induced hepatic encephalopathy (HE) in rats. The results showed that ARG restored serum and brain ammonia levels, improved liver function, behavioral alterations, and neuro-biochemical values. ARG also reduced inflammation and oxidative stress and improved immunological reactivity in the cerebellum and liver tissues. Overall, ARG played a beneficial role in modulating the adverse complications associated with TAA-induced HE in rats.
ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH
(2023)
Review
Immunology
Bo Yu, Yalong Zhang, Tianyu Wang, Jiayu Guo, Chenyang Kong, Zhongbao Chen, Xiaoxiong Ma, Tao Qiu
Summary: The mitogen-activated protein kinase (MAPK) signaling pathway, which can be triggered by various growth factors, cytokines, and hormones, plays a crucial role in regulating cellular activities such as cell proliferation, motility, and differentiation. It has been extensively studied in the context of inflammation and tumor development. Hepatic ischemia-reperfusion injury (HIRI) is a common pathological phenomenon occurring during surgical procedures like lobectomy and liver transplantation, characterized by severe inflammatory reaction following ischemia and reperfusion. This review mainly focuses on discussing the roles of p38, ERK1/2, JNK in the MAPK family, as well as TAK1 and ASK1 in the MAPKKK family, in HIRI, aiming to identify effective treatments for HIRI.
JOURNAL OF INFLAMMATION RESEARCH
(2023)
Review
Biochemistry & Molecular Biology
Kaihui Lu
Summary: Hepatic encephalopathy (HE) is a neuropsychiatric syndrome caused by metabolic disorders in the liver. It is characterized by hyperammonemia, EEG abnormalities, and disturbances in sensory, motor, and cognitive functions. The main mechanisms of HE include ammonia poisoning, oxidative/nitrosative stress, manganese toxicity, autophagy inhibition, mitochondrial damage, inflammation, and senescence.
Review
Gastroenterology & Hepatology
Dominique Thabut, Charlotte Bouzbib, Lucy Meunier, Manon Haas, Nicolas Weiss, Alexandre Louvet, Francois Imbert-Bismut, Fanny Mochel, Yann Nadjar, Antoine Santiago, Thierry Thevenot, Veronique Duhalde, Frederic Oberti, Claire Francoz, Audrey Coilly, Marie-Noelle Hilleret, Pascal Lebray, Amelie Liou-Schischmanoff, Louise Barbier, Christophe Duvoux, Georges-Philippe Pageaux, Michael Bismuth, Damien Galanaud, Thomas De Broucker, Jean-Francois Cadranel, Vincent Leroy, Vincent Di Martino, Dominique Larrey, Christophe Camus, Olivier Scatton, Victor De Ledinghen, Ariane Mallat, Marika Rudler, Christophe Bureau
Summary: Hepatic encephalopathy (HE) is a frequent and severe complication of liver disease that often goes undiagnosed due to a lack of understanding and consensus on diagnosis. Non-specific symptoms and comorbidities in cirrhotic patients make differential diagnosis challenging. Guidelines are provided to assist clinicians in diagnosing and treating HE. Liver transplantation may be indicated for HE, but its reversibility post-transplantation and the consequences in patients with other neurological disorders remain controversial.
LIVER INTERNATIONAL
(2023)
Review
Gastroenterology & Hepatology
Leen Z. Hasan, George Y. Wu
Summary: Hepatic encephalopathy is a devastating complication of chronic liver disease with high mortality rates, and current treatment modalities, while promising, are limited by study design and lack of safety data.Various treatment options targeting gut microbiota, oxidative stress, and neurotransmitter modulation have shown promise but more research is needed to address their limitations.
JOURNAL OF CLINICAL AND TRANSLATIONAL HEPATOLOGY
(2021)
Article
Biochemical Research Methods
Katerina Kroupina, Chantal Bemeur, Christopher F. Rose
Summary: Hepatic encephalopathy is a decline in brain function caused by liver insufficiency. The liver's reduced ability to clear ammonia plays a crucial role in the development of hepatic encephalopathy. Cirrhotic patients require high protein intake, but this can increase the accumulation of ammonia, worsening hepatic encephalopathy. Finding a nutritional solution that provides sufficient protein doses without increasing the risk of hepatic encephalopathy is necessary.
ANALYTICAL BIOCHEMISTRY
(2022)
Article
Integrative & Complementary Medicine
Chen Tzufan, Chen Chuntzu, Huang Yuanli, Baskaran Rathinasamy, J. p tsai Jeffrey, H. U. Rouhmei
Summary: The study evaluated the immune modulatory response of Puhuang, showing that its extracts have inhibitory effects on inflammatory activity of macrophage cells and work by inhibiting the expression of inflammatory regulators. The phytochemical constituents present in Typha angustifolia Linn exhibit strong antioxidant activities and high levels of flavonoids and phenolic contents.
JOURNAL OF TRADITIONAL CHINESE MEDICINE
(2021)
Article
Biochemistry & Molecular Biology
Shu Yang, Jianhong Wang, Duozi Wang, Lei Guo, Dalin Yu
Summary: Ramelteon ameliorates LPS-induced inflammatory responses in astrocytes by reducing expressions of inflammatory cytokines and inhibiting the TLR4/I kappa B alpha/NF-kappa B p65 axis, suggesting its potential as a protective agent against LPS-induced damage in astrocytes.
ACS CHEMICAL NEUROSCIENCE
(2021)
Article
Gastroenterology & Hepatology
Stefania Gioia, Lorenzo Ridola, Ludovica Cristofaro, Manuela Merli, Jessica Faccioli, Oliviero Riggio, Silvia Nardelli
Summary: This study found that after TIPS procedure, not only muscle mass but also adipose tissue underwent changes. Improvement in subcutaneous adipose tissue, sarcopenia, and myosteatosis were associated with cognitive impairment improvement, independently of liver function. The correlation between adipose tissue and ammonia modification suggests a potential role of adipose tissue in ammonia trafficking between organs.
LIVER INTERNATIONAL
(2021)
Review
Medicine, General & Internal
Daniele Bellafante, Stefania Gioia, Jessica Faccioli, Oliviero Riggio, Lorenzo Ridola, Silvia Nardelli
Summary: Hepatic encephalopathy (HE) is a common complication in advanced liver disease, characterized by neurological and psychiatric symptoms. Malnutrition and portosystemic shunts have recently been identified as new precipitating factors for HE, in addition to known factors such as infections and gastrointestinal bleeding. It is crucial to identify, manage, and correct these factors for effective treatment of HE, along with pharmacological therapy.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Endocrinology & Metabolism
Anne Catrine Daugaard Mikkelsen, Karen Louise Thomsen, Hendrik Vilstrup, Niels Kristian Aagaard
Summary: Patients with cirrhosis are prone to electrolyte disorders, including hypokalaemia, which can lead to an increased risk of hepatic encephalopathy. Hypokalaemia stimulates renal ammonia production and reduces hepatic ammonia elimination, resulting in hyperammonaemia. Furthermore, hypokalaemia facilitates the entrance of ammonia into the central nervous system and increases the amount of gaseous ammonia passing the blood brain barrier. Correcting low potassium levels is crucial in the management of cirrhosis patients to prevent hepatic encephalopathy.
METABOLIC BRAIN DISEASE
(2023)
Article
Environmental Sciences
Mohammed S. Mahmoud, Attalla F. El-Kott, Hussah I. M. AlGwaiz, Samah M. Fathy
Summary: The present study found that Moringa oleifera Lam. leaf ethanolic extract (MOLE) has antioxidative, anti-inflammatory, antiapoptotic, and anti-depression impacts in a CCl4-induced hepatic encephalopathy mouse model. MOLE decreases liver damage indicators, improves antioxidant status, reduces inflammation and apoptosis, and attenuates anxiety and depression-like behaviors.
ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH
(2022)