Ammonia and the Muscle: An Emerging Point of View on Hepatic Encephalopathy

Cola, Simone Di; Nardelli, Silvia; Gioia, Stefania; Riggio, Oliviero; Merli, Manuela

doi:10.3390/jcm11030611

Cited by 14 publications

(7 citation statements)

References 79 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This effect could be the result of the amelioration of myosteatosis (see above), local and systemic inflammation, and oxidative stress, which all contribute negatively to muscle performance [75][76][77]. In addition, the reduction in blood and tissue ammonia content (most importantly, in the skeletal muscle and the heart), and therefore its toxicity, could prove beneficial for myofibre metabolism and function [78,79].…”

Section: Discussionmentioning

confidence: 99%

Glycyrrhizinic Acid and Phosphatidylcholine Combination as a Preventive Therapy for Experimental Murine Non-Alcoholic Steatohepatitis

Prikhodko,

Matuzok,

Karev

et al. 2024

Livers

View full text Add to dashboard Cite

Non-alcoholic metabolic-associated steatohepatitis (MASH) is a condition characterized by increasingly high prevalence and incidence, and also represents an important unmet medical need when it comes to effective pharmacotherapy. In this work, we aimed to explore the therapeutic possibilities of the synergistic combined use of glycyrrhizinic acid (GA) and phosphatidylcholine (PC) to prevent experimental MASH. Adult C57Bl/6 mice were used to model dietary/toxic MASH and treated orally by either GA (34.3 mg/kg/d) or a GA + PC combination (34.3 + 158.1 mg/kg/d) for 3 months. Animal locomotion, behaviour, short-term memory, physical performance, neuromuscular joint function, blood biochemistry, and oxidative stress marker levels were evaluated, followed by histological examination of the liver, skeletal muscle and sciatic nerve with tissue ammonia and lipid content determination. Real-time polymerase chain reaction was used to measure the relative expression of several pathogenetic transcript markers. GA and PC showed moderate additive synergism in their anti-inflammatory, antioxidant, hypoammonaemic, hypoglycaemic, and pro-cognitive activities. Differential effects of the agents were seen in regard to anxiety- and depression-like behaviour as well as gene expression. Our results indicate partial pharmacological synergism between GA and PC and validate further research of its potential clinical applications.

show abstract

Section: Discussionmentioning

confidence: 99%

Glycyrrhizinic Acid and Phosphatidylcholine Combination as a Preventive Therapy for Experimental Murine Non-Alcoholic Steatohepatitis

Prikhodko,

Matuzok,

Karev

et al. 2024

Livers

View full text Add to dashboard Cite

show abstract

“… 11 ) Muscles are also a major metabolizing organ of ammonia, and the presence of sarcopenia increases the risk for HE. 12 , 13 ) Therefore, older age increases the likelihood of developing overt HE or manifesting psychiatric symptoms of HE.…”

Section: Discussionmentioning

confidence: 99%

Marked Cognitive and Activities of Daily Living Improvement by Shunt Embolization in a Very Old Man with Portosystemic Encephalopathy Mimicking Alzheimer Disease: A Case Report

Kondo¹,

Takada²,

Kojima³

et al. 2022

Ann Geriatr Med Res

View full text Add to dashboard Cite

A 91-year-old man with chronic cognitive impairment underwent shunt embolization for portosystemic encephalopathy (PSE). He experienced intermittent episodes of impaired consciousness and decreased cognitive function and activities of daily living (ADL), for which Alzheimer's disease was suspected. On admission, he was in a coma and PSE was diagnosed based on his high ammonia level and the computed tomography (CT) findings. After shunt embolization, the patient fully recovered from the impaired consciousness and experienced no recurrence. The patient's Revised Hasegawa Dementia Scale (HDS-R) and Mini-Mental State Examination (MMSE) scores improved significantly from 12 and 17 to 30 and 29 points, respectively. The Barthel index score also improved from 55/100 to 85/100, suggesting a marked improvement in ADL. PSE progresses slowly in very old patients and may mimic the clinical course of Alzheimer's disease but without liver enzyme abnormalities. Therefore, it should be distinguished in every dementia case.

show abstract

“…Muscle alterations are frequent in patients with liver cirrhosis and include the loss of muscle mass (sarcopenia) and the infiltration of muscle mass by intermuscular and intramuscular fat (myosteatosis) [56]. Both conditions are frequent in patients with chronic liver disease [57]; in fact, sarcopenia is observed in up to 70% of cirrhotic patients, and it is associated to a higher mortality in these patients [58,59].…”

Section: Muscle Alterationsmentioning

confidence: 99%

Old and New Precipitants in Hepatic Encephalopathy: A New Look at a Field in Continuous Evolution

Bellafante

Gioia

Faccioli

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

Hepatic encephalopathy (HE) is a common complication in patients with advanced liver disease. It is a brain dysfunction characterized by neurological and psychiatric symptoms that significantly affects quality of life, morbidity and mortality of patients. HE has various precipitants that can potentially promote its onset, alone or in combination. Among the historically well-known precipitants, such as infections, gastrointestinal bleeding, dehydration, electrolyte disorders and constipation, recent studies have highlighted the role of malnutrition and portosystemic shunts as new precipitating factors of HE. The identification, management and correction of these factors are fundamental for effective HE treatment, in addition to pharmacological therapy with non-absorbable disaccharides and/or antibiotics.

show abstract

Ammonia and the Muscle: An Emerging Point of View on Hepatic Encephalopathy

Cited by 14 publications

References 79 publications

Glycyrrhizinic Acid and Phosphatidylcholine Combination as a Preventive Therapy for Experimental Murine Non-Alcoholic Steatohepatitis

Glycyrrhizinic Acid and Phosphatidylcholine Combination as a Preventive Therapy for Experimental Murine Non-Alcoholic Steatohepatitis

Marked Cognitive and Activities of Daily Living Improvement by Shunt Embolization in a Very Old Man with Portosystemic Encephalopathy Mimicking Alzheimer Disease: A Case Report

Old and New Precipitants in Hepatic Encephalopathy: A New Look at a Field in Continuous Evolution

Contact Info

Product

Resources

About