Efficacy of oral L-ornithine L-aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy.
Hyperammonemia and associated cerebral edema cause neurological abnormalities in liver disease patients. Although only 15% of ammonia production originates in the colon, management strategies for hepatic encephalopathy (HE) have focused on reducing ammonia generation from the bowel rather than on manipulating systemic mechanisms involved in ammonia metabolism. Administration of L-ornithine L-aspartate (LOLA) improves mental status and decreases serum and spinal fluid ammonia levels by stimulating both the urea cycle and glutamine (Gln) synthesis, which are key metabolic pathways in ammonia detoxification. LOLA was shown to be superior to a placebo for management of HE, and the results of several clinical trials suggest that its effectiveness could be higher with the more severe grades of this syndrome. Compared with the standard treatment, LOLA is effective not only in reducing hyperammonemia and the severity of this disease, but also in improving the patient's perceived quality of life. Therefore, LOLA is a promising alternative  for the management of HE.
Servicio de Gastroenterología. Hospital Universitario Dr. José Eleuterio          González, Facultad de Medicina. Universidad Autónoma de Nuevo León.  Monterrey, Nuevo León, México.
Claudia Isabel
CI
Blanco Vela
Jorge Luis
JL
Poo Ramírez
D000284:Administration, Oral; D000641:Ammonia / Q000378:metabolism; D004151:Dipeptides / Q000008:administration & dosage / Q000627:therapeutic use*; D005973:Glutamine / Q000378:metabolism; D006501:Hepatic Encephalopathy / Q000188:drug therapy* / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D022124:Hyperammonemia / Q000188:drug therapy* / Q000209:etiology* / Q000378:metabolism; D008103:Liver Cirrhosis / Q000150:complications*; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014508:Urea / Q000378:metabolism
D004151:Dipeptides; D005973:Glutamine; D000641:Ammonia; D014508:Urea; C002939:ornithylaspartate