title: Novel Ammonia-Lowering Agents for Hepatic Encephalopathy.
abstract: Hepatic encephalopathy (HE) is a common complication of cirrhosis, leading to frequent hospitalizations. Because ammonia is thought to play an important role in the pathogenesis of HE, therapies specifically aimed at reducing ammonia levels have been developed for conditions causing hyperammonemia, including HE. Ammonia scavengers have been used in HE patients, leading to improvements in symptoms. Bowel cleansing with polyethylene glycol has also been studied recently, resulting in more rapid improvement in acute HE compared with lactulose. Extracorporeal devices have been used in cases of refractory HE but currently are used primarily in research settings and not approved for clinical management for HE.
authors.affiliation: Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth Street, Suite 860, Dallas, TX 75246, USA. Electronic address: robert.rahimi@baylorhealth.edu.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Rahimi
authors.affiliation: Department of Internal Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Room 803 CSB, Charleston, SC 29425, USA.
authors.forename: Don C
authors.initials: DC
authors.lastname: Rockey
mesh_terms: D000641:Ammonia / Q000097:blood*; D002244:Carbon / Q000627:therapeutic use*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D005990:Glycerol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006501:Hepatic Encephalopathy / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D009952:Ornithine / Q000031:analogs & derivatives / Q000627:therapeutic use; D010087:Oxides / Q000627:therapeutic use*; D010654:Phenylbutyrates / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D014508:Urea / Q000378:metabolism
chemical_list: D005765:Gastrointestinal Agents; D010087:Oxides; D010654:Phenylbutyrates; D011092:Polyethylene Glycols; D002244:Carbon; D000641:Ammonia; D014508:Urea; C040896:AST 120; C572232:ornithine phenylacetate; D009952:Ornithine; D005990:Glycerol; C570223:glycerol phenylbutyrate
keywords: AST-120; Benzoate; Cirrhosis; Glycerol phenylbutyrate; MARS; Ornithine phenylacetate; PEG; Polyethylene glycol