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Sivolap Iu.P.

Moskovskaia meditsinskaia akademiia im. I.M. Sechenova

Prevention and treatment of hepatic encephalopathy

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Sivolap Iu.P.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2017;117(10): 144‑147

DOI: 10.17116/jnevro2017117101144-147

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PREVENTION AND TREATMENT OF HEPATIC ENCEPHALOPATHY
PREVENTION AND TREATMENT OF HEPATIC ENCEPHALOPATHY

To cite this article:

Sivolap IuP. Prevention and treatment of hepatic encephalopathy. S.S. Korsakov Journal of Neurology and Psychiatry. 2017;117(10):144‑147. (In Russ.)
https://doi.org/10.17116/jnevro2017117101144-147

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова (S.S. Korsakov Journal of Neurology and Psychiatry)
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Использование инфографики авторами научных работ
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Abstract:

Hepatic encephalopathy is a common neuropsychiatric complication of serious liver diseases and serves as a marker for worsening of their course and increasing the risk of death. The principal pathogenesis factors of hepatic encephalopathy is the excessive formation of ammonia and its accumulation by astrocytes. A key role in the prevention and treatment of hepatic encephalopathy is played by drugs that prevent hyperammonemia and promote the removal of ammonia from the body, namely lactulose, rifaximin and L-ornithine-L-aspartate. L-ornithine-L-aspartate has proven clinical effectiveness in the treatment of hepatic encephalopathy, prevents the transformation of minimal hepatic encephalopathy into overt forms, increases the tolerability of psychotropic drugs used in the treatment of alcohol dependence, and improves cognitive functions.

Keywords:

hepatic encephalopathy
ammonia
hyperammonemia
astrocytes
liver cirrhosis
portosystemic shunting
alcohol liver disease
lactulose
rifaximin
L-ornithine-L-aspartate

Authors:

Sivolap Iu.P.

Moskovskaia meditsinskaia akademiia im. I.M. Sechenova

Close metadata

References:

  1. Elwir S, Rahimi RS. Hepatic encephalopathy: an update on the pathophysiology and therapeutic options. J Clin Transl Hepatol. 2017;5(2):142-151. https://doi.org/10.14218/JCTH.2016.00069
  2. Rahimi RS, Rockey DC. Novel ammonia-lowering agents for hepatic encephalopathy. Clin Liver Dis. 2015;19(3):539-549. https://doi.org/10.1016/j.cld.2015.04.008
  3. Sussman NL. Treatment of overt hepatic encephalopathy. Clin Liver Dis. 2015;19(3):551-563. https://doi.org/10.1016/j.cld.2015.04.005
  4. Sheasgreen C, Lu L, Patel A. Pathophysiology, diagnosis, and management of hepatic encephalopathy. Inflammopharmacology. 2014;22(6):319-326. https://doi.org/10.1007/s10787-014-0217-9
  5. Henderson PK, Herrera JL. Should we treat minimal/covert hepatic encephalopathy, and with what? Clin Liver Dis. 2015;19(3):487-95. https://doi.org/10.1016/j.cld.2015.04.002
  6. Schulz C, Schütte K, Kropf S, Schmitt FC, Vasapolli R, Kliegis LM, Riegger A, Malfertheiner P. RiMINI — the influence of rifaximin on minimal hepatic encephalopathy (MHE) and on the intestinal microbiome in patients with liver cirrhosis: study protocol for a randomized controlled trial. Trials. 2016;17(1):111. https://doi.org/10.1186/s13063-016-1205-8
  7. Sharma K, Pant S, Misra S, Dwivedi M, Misra A, Narang S, Tewari R, Bhadoria AS. Effect of rifaximin, probiotics, and l-ornithine l-aspartate on minimal hepatic encephalopathy: a randomized controlled trial. Saudi J Gastroenterol. 2014;20(4):225-232. https://doi.org/10.1002/hep.29410
  8. Ott P, Vilstrup H. Cerebral effects of ammonia in liver disease: current hypotheses. Metab Brain Dis. 2014;29(4):901-911. https://doi.org/10.1007/s11011-014-9494-7
  9. Bismuth M, Funakoshi N, Cadranel JF, Blanc P. Hepatic encephalopathy: from pathophysiology to therapeutic management. Eur J Gastroenterol Hepatol. 2011;23(1):8-22. https://doi.org/10.1097/MEG.0b013e3283417567
  10. Hadjihambi A, Arias N, Sheikh M, Jalan R. Hepatic encephalopathy: a critical current review. Hepatol Int. 2017. https://doi.org/10.1007/s12072-017-9812-3
  11. Shabrang B, Jamshidzadeh A, Farjam M, Ebrahimpour A, Koohi-Hosseinabadi O. Concurrent assessment of calpain and caspase3 activities in brains of mice with acetaminophen-induced acute hepatic encephalopathy. Metab Brain Dis. 2017. https://doi.org/10.1007/s11011-017-0096-z
  12. Dasarathy S, Mookerjee RP, Rackayova V, Rangroo Thrane V, Vairappan B, Ott P, Rose CF. Ammonia toxicity: from head to toe? Metab Brain Dis. 2017;32(2):529-538. https://doi.org/10.1007/s11011-016-9938-3
  13. Cruz NF, Dienel GA, Patrick PA, Cooper AJL. Organ distribution of 13N following intravenous injection of [13N] ammonia into portacaval-shunted rats. Neurochem Res. 2017;42(6):1683-1696. https://doi.org/10.1007/s11064-016-2096-5
  14. Kumar A, Davuluri G, Silva RNE, Engelen MPKJ, Ten Have GAM, Prayson R, Deutz NEP, Dasarathy S. Ammonia lowering reverses sarcopenia of cirrhosis by restoring skeletal muscle proteostasis. Hepatology. 2017;65(6): 2045-2058. https://doi.org/10.1002/hep.29107
  15. Petersen KU. Options in the treatment of hepatic encephalopathy. Med Monatsschr Pharm. 2015;38(5):160-164.
  16. Kircheis G, Nilius R, Held C, Berndt H, Buchner M, Görtelmeyer R, Hendricks R, Krüger B, Kuklinski B, Meister H, Otto HJ, Rink C, Rösch W, Stauch S. Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study. Hepatology. 1997;25(6):1351-1360. https://doi.org/10.1002/hep.510250609
  17. Kircheis G, Wettstein M, Dahl Sv, Häussinger D. Clinical efficacy of L-ornithine-L-aspartate in the management of hepatic encephalopathy. Metab Brain Dis. 2002;17(4):453-462. https://doi.org/10.1007/s11011-016-9912-0
  18. Bai M, He C, Yin Z, Niu J, Wang Z, Qi X, Liu L, Yang Z, Guo W, Tie J, Bai W, Xia J, Cai H, Wang J, Wu K, Fan D, Han G. Randomised clinical trial: L-ornithine-L-aspartate reduces significantly the increase of venous ammonia concentration after TIPSS. Aliment Pharmacol Ther. 2014;40(1):63-71. https://doi.org/10.1111/apt.12795
  19. Sidhu SS, Sharma BC, Goyal O, Kishore H, Kaur N. L-ornithine L-aspartate in bouts of overt hepatic encephalopathy. Hepatology. 2017. https://doi.org/10.1002/hep.29410
  20. Alvares-da-Silva MR, de Araujo A, Vicenzi JR, da Silva GV, Oliveira FB, Schacher F, Oliboni L, Magnus A, Kruel LP, Prieb R, Fernandes LN. Oral l-ornithine-l-aspartate in minimal hepatic encephalopathy: a randomized, double-blind, placebo-controlled trial. Hepatol Res. 2014;44(9):956-963.
  21. Rahimi RS, Rockey DC. Hepatic encephalopathy: pharmacological therapies targeting ammonia. Semin Liver Dis. 2016;36(1):48-55. https://doi.org/10.1055/s-0036-1571298
  22. Goh ET, Andersen ML, Morgan MY, Gluud LL. Flumazenil versus placebo or no intervention for people with cirrhosis and hepatic encephalopathy. Cochrane Database Syst Rev. 2017;8:CD002798. https://doi.org/10.1002/14651858.CD002798.pub4
  23. Holeček M. Branched-chain amino acid supplementation in treatment of liver cirrhosis: updated views on how to attenuate their harmful effects on cataplerosis and ammonia formation. Nutrition. 2017;41:80-85. https://doi.org/10.1016/j.nut.2017.04.003
  24. Prakash RK, Kanna S, Mullen KD. Evolving concepts: the negative effect of minimal hepatic encephalopathy and role for prophylaxis in patients with cirrhosis. Clin Ther. 2013;35(9):1458-1473. https://doi.org/10.1016/j.clinthera.2013.07.421
  25. Prakash R, Mullen KD. Mechanisms, diagnosis and management of hepatic encephalopathy. Nat Rev Gastroenterol Hepatol. 2010;7(9):515-525. https://doi.org/10.1038/nrgastro.2010.116
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