Pathophysiology of Hepatic Encephalopathy

被引：39

作者：

Jaffe, Ariel ^{[1
]}

Lim, Joseph K. ^{[1
,2
]}

Jakab, Sofia Simona ^{[1
,2
]}

机构：

[1] Yale Univ, Yale Liver Ctr, Sect Digest Dis, Sch Med, 333 Cedar St,LMP 1080, New Haven, CT 06520 USA

[2] VA Connecticut Healthcare Syst, West Haven, CT 06516 USA

来源：

CLINICS IN LIVER DISEASE | 2020年 / 24卷 / 02期

关键词：

Liver cirrhosis; Hepatic encephalopathy; Ammonia; Neurotoxicity; TNF-Alpha; Gut-liver-brain axis; Neurotransmitters; Cannabinoids; NECROSIS-FACTOR-ALPHA; PROTON PUMP INHIBITORS; LIVER-BRAIN AXIS; RISK-FACTOR; MANGANESE NEUROTOXICITY; BACTERIAL TRANSLOCATION; COGNITIVE IMPAIRMENT; CIRRHOTIC-PATIENTS; DIABETES-MELLITUS; DOUBLE-BLIND;

D O I：

10.1016/j.cld.2020.01.002

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Hepatic encephalopathy (HE) is one of the major clinical decompensations of cirrhosis, with a high impact on health care resource utilization and cost. For an effective and comprehensive management of HE, the clinicians need to understand the pathophysiologic mechanisms of HE. This review describes the multiorgan processes involved in HE and how several HE precipitants and treatment strategies act on ammonia production, excretion, and neurotoxicity, including the impact of diabetes and use of canna-binoids. The authors also discuss the current and future role of gut microbiome, systemic/central inflammation, and various neurotransmitters for the pathogenesis and treatment of HE.

引用

页码：175 / +

页数：15

共 79 条

[1] The acute effect of cannabis on plasma, liver and brain ammonia dynamics, a translational study [J].

Abulseoud, Osama A. ;

Zuccoli, Maria Laura ;

Zhang, Lifeng ;

Barnes, Allan ;

Huestis, Marilyn A. ;

Lin, Da-Ting .

EUROPEAN NEUROPSYCHOPHARMACOLOGY, 2017, 27 (07) :679-690

[2]

AGGARWAL S, 1994, HEPATOLOGY, V19, P80, DOI 10.1002/hep.1840190114

[3] Increased brain concentrations of a neuroinhibitory steroid in human hepatic encephalopathy [J].

Ahboucha, S ;

Layrargues, GP ;

Mamer, O ;

Butterworth, RF .

ANNALS OF NEUROLOGY, 2005, 58 (01) :169-170

[4] GABAergic neurosteroids: The "endogenous benzodiazepines" of acute liver failure [J].

Ahboucha, Samir ;

Gamrani, Halima ;

Baker, Glen .

NEUROCHEMISTRY INTERNATIONAL, 2012, 60 (07) :707-714

[5] Impaired Gut-Liver-Brain Axis in Patients with Cirrhosis [J].

Ahluwalia, Vishwadeep ;

Betrapally, Naga S. ;

Hylemon, Phillip B. ;

White, Melanie B. ;

Gillevet, Patrick M. ;

Unser, Ariel B. ;

Fagan, Andrew ;

Daita, Kalyani ;

Heuman, Douglas M. ;

Zhou, Huiping ;

Sikaroodi, Masoumeh ;

Bajaj, Jasmohan S. .

SCIENTIFIC REPORTS, 2016, 6

[6] Glutamine: A Trojan horse in ammonia neurotoxicity [J].

Albrecht, Jan ;

Norenberg, Michael D. .

HEPATOLOGY, 2006, 44 (04) :788-794

[7] Updates on the pathophysiology and therapeutic targets for hepatic encephalopathy [J].

Alsahhar, Jamil S. ;

Rahimi, Robert S. .

CURRENT OPINION IN GASTROENTEROLOGY, 2019, 35 (03) :145-154

[8] Role of diabetes mellitus on hepatic encephalopathy [J].

Ampuero, Javier ;

Ranchal, Isidora ;

del Mar Diaz-Herrero, Maria ;

Antonio del Campo, Jose ;

Bautista, Juan D. ;

Romero-Gomez, Manuel .

METABOLIC BRAIN DISEASE, 2013, 28 (02) :277-279

[9] Metformin Inhibits Glutaminase Activity and Protects against Hepatic Encephalopathy [J].

Ampuero, Javier ;

Ranchal, Isidora ;

Nunez, David ;

del Mar Diaz-Herrero, Maria ;

Maraver, Marta ;

Antonio del Campo, Jose ;

Rojas, Angela ;

Camacho, Ines ;

Figueruela, Blanca ;

Bautista, Juan D. ;

Romero-Gomez, Manuel .

PLOS ONE, 2012, 7 (11)

[10]

[Anonymous], 2004, COCHRANE DB SYST REV

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