title: Rifaximin, but not growth factor 1, reduces brain edema in cirrhotic rats.
abstract: OBJECTIVE
  To compare rifaximin and insulin-like growth factor (IGF)-1 treatment of hyperammonemia and brain edema in cirrhotic rats with portal occlusion.
  
  
  METHODS
  Rats with CCl₄-induced cirrhosis with ascites plus portal vein occlusion and controls were randomized into six groups: Cirrhosis; Cirrhosis + IGF-1; Cirrhosis + rifaximin; Controls; Controls + IGF-1; and Controls + rifaximin. An oral glutamine-challenge test was performed, and plasma and cerebral ammonia, glucose, bilirubin, transaminases, endotoxemia, brain water content and ileocecal cultures were measured and liver histology was assessed.
  
  
  RESULTS
  Rifaximin treatment significantly reduced bacterial overgrowth and endotoxemia compared with cirrhosis groups, and improved some liver function parameters (bilirubin, alanine aminotransferase and aspartate aminotransferase). These effects were associated with a significant reduction in cerebral water content. Blood and cerebral ammonia levels, and area-under-the-curve values for oral glutamine-challenge tests were similar in rifaximin-treated cirrhotic rats and control group animals. By contrast, IGF-1 administration failed to improve most alterations observed in cirrhosis.
  
  
  CONCLUSIONS
  By reducing gut bacterial overgrowth, only rifaximin was capable of normalizing plasma and brain ammonia and thereby abolishing low-grade brain edema, alterations associated with hepatic encephalopathy.
authors.affiliation: Hepatology Unit, Department of Gastroenterology, Germans Trias i Pujol Health Science Research Institute, 08916 Badalona, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Odena
authors.forename: Mireia
authors.initials: M
authors.lastname: Miquel
authors.forename: Anna
authors.initials: A
authors.lastname: Serafín
authors.forename: Amparo
authors.initials: A
authors.lastname: Galan
authors.forename: Rosa
authors.initials: R
authors.lastname: Morillas
authors.forename: Ramon
authors.initials: R
authors.lastname: Planas
authors.forename: Ramon
authors.initials: R
authors.lastname: Bartolí
mesh_terms: D000641:Ammonia / Q000378:metabolism; D000818:Animals; D001419:Bacteria / Q000302:isolation & purification; D001835:Body Weight / Q000187:drug effects; D001921:Brain / Q000378:metabolism / Q000473:pathology; D001929:Brain Edema / Q000188:drug therapy*; D002432:Cecum / Q000382:microbiology; D004731:Endotoxins / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000627:therapeutic use*; D008106:Liver Cirrhosis, Experimental / Q000150:complications* / Q000473:pathology; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin
chemical_list: D004731:Endotoxins; D012294:Rifamycins; D007334:Insulin-Like Growth Factor I; D000641:Ammonia; D000078262:Rifaximin