Hepatic encephalopathy in cirrhosis: therapies and developments.

IF 3.5 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Ajay Kumar Mishra, Radha Krishan Dhiman
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引用次数: 0

Abstract

Hepatic encephalopathy (HE) is a frequent decompensation in patients with cirrhosis, which significantly affects morbidity and mortality. Ammonia is a major neurotoxin implicated in the pathogenesis, progression, and severity of HE, and various organs including the gut, muscle, kidney, and brain are involved in its metabolism. Therefore, therapeutic management involves reducing ammonia production and increasing its elimination from the blood and the brain. Prevention of HE in patients at high risk of first and recurrent episodes is important for prolonging survival. Various anti-ammonia therapies with synergistic and complementary actions have been attempted for overt HE and for prophylaxis of the first and recurrent episodes of HE. In the current review, we summarize the currently used and under-development pharmacotherapies/procedure(s) for HE in cirrhosis and their mechanism of action. Primary and secondary prophylaxis with monotherapies and combination therapies are also discussed.

肝硬化肝性脑病:治疗和发展。
肝性脑病(HE)是肝硬化患者常见的代偿失代偿,严重影响发病率和死亡率。氨是一种主要的神经毒素,与HE的发病、进展和严重程度有关,包括肠道、肌肉、肾脏和大脑在内的各种器官都参与其代谢。因此,治疗管理包括减少氨的产生和增加其从血液和大脑的消除。在首次发作和复发的高风险患者中预防HE对于延长生存期很重要。各种具有协同和互补作用的抗氨疗法已被尝试用于显性HE和预防HE的首次和复发发作。在当前的综述中,我们总结了目前用于肝硬化HE的和正在开发的药物治疗/程序及其作用机制。初级和二级预防与单一治疗和联合治疗也进行了讨论。
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来源期刊
Metabolic brain disease
Metabolic brain disease 医学-内分泌学与代谢
CiteScore
5.90
自引率
5.60%
发文量
248
审稿时长
6-12 weeks
期刊介绍: Metabolic Brain Disease serves as a forum for the publication of outstanding basic and clinical papers on all metabolic brain disease, including both human and animal studies. The journal publishes papers on the fundamental pathogenesis of these disorders and on related experimental and clinical techniques and methodologies. Metabolic Brain Disease is directed to physicians, neuroscientists, internists, psychiatrists, neurologists, pathologists, and others involved in the research and treatment of a broad range of metabolic brain disorders.
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