The usefulness of branched chain amino acids in patients with acute or chronic hepatic encephalopathy.
Hepatic encephalopathy (HE) is a neuropsychiatric syndrome associated with acute liver failure or chronic parenchymal liver disease. It has been hypothesized that changes in protein and amino acid metabolism and catabolism contribute to the pathogenesis of HE. Clinical investigations into the use of branched chain amino acids (BCAA) in the therapy of nutritional support for patients with HE have markedly increased. We have reviewed the rational basis for, and the controversies related to, the use of BCAA in the treatment of HE. We conclude that data on the use of BCAA in HE are controversial. There is marked variation in study design, and often, a lack of appropriate controls in patient numbers, as well as in consistent use of comparable measures of response. The ultimate role for BCAA in the treatment of HE is uncertain and will require additional objective information from well-designed and controlled clinical studies.
Alexander
W F
WF
Division of Gastroenterology, Hepatology and Nutrition, University of Florida College of Medicine, Gainesville.
Spindel
E
E
Harty
R F
RF
Cerda
J J
JJ
D000597:Amino Acids, Branched-Chain / Q000627:therapeutic use*; D000818:Animals; D006501:Hepatic Encephalopathy / Q000188:drug therapy* / Q000209:etiology; D006801:Humans
D000597:Amino Acids, Branched-Chain