Mechanisms of ammonia-induced astrocyte swelling.
Astrocyte swelling represents the major factor responsible for the brain edema associated with fulminant hepatic failure (FHF). The edema may be of such magnitude as to increase intracranial pressure leading to brain herniation and death. Of the various agents implicated in the generation of astrocyte swelling, ammonia has had the greatest amount of experimental support. This article reviews mechanisms of ammonia neurotoxicity that contribute to astrocyte swelling. These include oxidative stress and the mitochondrial permeability transition (MPT). The involvement of glutamine in the production of cell swelling will be highlighted. Evidence will be provided that glutamine induces oxidative stress as well as the MPT, and that these events are critical in the development of astrocyte swelling in hyperammonemia.
Norenberg
M D
MD
Veterans Affairs Medical Center, Miami, Florida 33101, USA. mnorenbe@med,miami.edu
Rao
K V Rama
KV
Jayakumar
A R
AR
D000641:Ammonia / Q000633:toxicity*; D000818:Animals; D020346:Aquaporins / Q000502:physiology; D001253:Astrocytes / Q000187:drug effects* / Q000648:ultrastructure; D048429:Cell Size; D005973:Glutamine / Q000502:physiology; D005978:Glutathione / Q000502:physiology; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism; D008928:Mitochondria / Q000187:drug effects; D018377:Neurotransmitter Agents / Q000502:physiology; D018384:Oxidative Stress / Q000502:physiology; D010539:Permeability; D011963:Receptors, GABA-A / Q000502:physiology; D013256:Steroids / Q000502:physiology
D020346:Aquaporins; D018377:Neurotransmitter Agents; D011963:Receptors, GABA-A; D013256:Steroids; D005973:Glutamine; D019344:Lactic Acid; D000641:Ammonia; D005978:Glutathione