title: Evidence for oxidative/nitrosative stress in the pathogenesis of hepatic encephalopathy.
abstract: Hepatic encephalopathy (HE) is a serious complication of liver failure. HE manifests as a series of neuropsychiatric and neuromuscular symptoms including personality changes, sleep abnormalities, asterixis and muscle rigidity progressing through stupor to coma. The pathophysiologic basis of HE remains unclear. There is general agreement that ammonia plays a key role. In recent years, it has been suggested that oxidative/nitrosative stress constitutes part of the pathophysiologic cascade in HE. Direct evidence for oxidative/nitrosative stress in the pathogenesis of HE has been demonstrated in experimental animal models of acute or chronic liver failure. However, evidence from studies in HE patients is limited. This review summarizes this evidence for a role of oxidative/nitrosative stress in relation to ammonia toxicity and to the pathogenesis of HE.
authors.affiliation: Neuroscience Research Unit, Hôpital Saint-Luc (CHUM) University of Montreal, Montreal, QC, Canada.
authors.forename: Chantal
authors.initials: C
authors.lastname: Bemeur
authors.forename: Paul
authors.initials: P
authors.lastname: Desjardins
authors.forename: Roger F
authors.initials: RF
authors.lastname: Butterworth
mesh_terms: D000818:Animals; D001921:Brain / Q000378:metabolism* / Q000503:physiopathology; D016207:Cytokines / Q000378:metabolism; D016166:Free Radical Scavengers / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D005609:Free Radicals / Q000378:metabolism; D006501:Hepatic Encephalopathy / Q000209:etiology* / Q000378:metabolism*; D006801:Humans; D022124:Hyperammonemia / Q000378:metabolism* / Q000503:physiopathology; D017093:Liver Failure / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D009566:Nitrates / Q000378:metabolism; D015538:Nitrosation / Q000502:physiology; D018384:Oxidative Stress / Q000502:physiology*
chemical_list: D016207:Cytokines; D016166:Free Radical Scavengers; D005609:Free Radicals; D009566:Nitrates