title: Altered metal metabolism in patients with HCV-related cirrhosis and hepatic encephalopathy.
abstract: Dysfunctional metal homeostasis contributes to oxidative stress and neuronal damage. These have been implicated in hepatic encephalopathy pathogenesis. To investigate whether altered metal metabolism is associated with hepatic encephalopathy. Twenty-one controls and 34 HCV-cirrhotic patients (ENC/NEC patients according to presence/absence of previous overt episodes of hepatic encephalopathy) and a control group were studied. Serum iron, copper, ceruloplasmin, ceruloplasmin activity, transferrin, and ceruloplasmin/transferrin ratio were determined. Neuropsychological tests were performed by the repeatable battery of neuropsychological status. Magnetic resonance assessed basal ganglia volumes and metal deposition (pallidal index and T2*). Cirrhotic patients performed worse than controls at cognitive tests, especially ENC patients,. At biochemical analysis copper concentrations, ceruloplasmin activity and transferrin levels were lower in ENC than in NEC patients and controls (p < 0.05 and p < 0.01, respectively). Ceruloplasmin/transferrin ratio was higher in ENC compared to NEC patients (p < 0.05), and controls (p < 0.01). By brain magnetic resonance, ENC patients showed reduced caudate and globus pallidus volumes compared to controls (p < 0.05), and ENC and NEC patients an increased pallidal index compared to controls (p < 0.01). In ENC patients, ceruloplasmin activity correlated with caudate volume and pallidal index (ρ = 0.773 and ρ = -0.683, p < 0.05). Altered metal metabolism likely contributes to cirrhotic hepatic encephalopathy.
authors: Neurology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy. m.marano@unicampus.it.
authors: Massimo
authors: M
authors: Marano
authors: Internal Medicine and Hepatology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy.
authors: Umberto
authors: U
authors: Vespasiani Gentilucci
authors: Neurology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy.
authors: Claudia
authors: C
authors: Altamura
authors: Don Carlo Gnocchi foundation ONLUS, Milan, Italy.
authors: Mariacristina
authors: M
authors: Siotto
authors: Fatebenefratelli Foundation, AFaR Division, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy.|Laboratorio di Neurodegenerazione, IRCCS San Raffaele Pisana, Rome, Italy.
authors: Rosanna
authors: R
authors: Squitti
authors: Laboratorio di Neurodegenerazione, IRCCS San Raffaele Pisana, Rome, Italy.
authors: Serena
authors: S
authors: Bucossi
authors: Clinical psychology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy.
authors: Livia
authors: L
authors: Quintiliani
authors: Clinical psychology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy.
authors: Simone
authors: S
authors: Migliore
authors: Radiology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy.
authors: Federico
authors: F
authors: Greco
authors: Radiology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy.
authors: Laura
authors: L
authors: Scarciolla
authors: Radiology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy.
authors: Carlo Cosimo
authors: CC
authors: Quattrocchi
authors: Internal Medicine and Hepatology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy.
authors: Antonio
authors: A
authors: Picardi
authors: Neurology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy.
authors: Fabrizio
authors: F
authors: Vernieri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002570:Ceruloplasmin / Q000378:metabolism; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000378:metabolism* / Q000523:psychology; D006526:Hepatitis C / Q000150:complications / Q000378:metabolism* / Q000523:psychology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008103:Liver Cirrhosis / Q000209:etiology / Q000378:metabolism* / Q000523:psychology; D008279:Magnetic Resonance Imaging; D008297:Male; D008670:Metals / Q000378:metabolism*; D008875:Middle Aged; D009483:Neuropsychological Tests; D012959:Socioeconomic Factors; D014168:Transferrin / Q000378:metabolism
chemical_list: D008670:Metals; D014168:Transferrin; D002570:Ceruloplasmin
keywords: Ammonia; Ceruloplasmin; Copper; Iron; Transferrin; Wilson’s disease