title: Inflammation: A novel target of current therapies for hepatic encephalopathy in liver cirrhosis.
abstract: Hepatic encephalopathy (HE) is a severe neuropsychiatric syndrome that most commonly occurs in decompensated liver cirrhosis and incorporates a spectrum of manifestations that ranges from mild cognitive impairment to coma. Although the etiology of HE is not completely understood, it is believed that multiple underlying mechanisms are involved in the pathogenesis of HE, and one of the main factors is thought to be ammonia; however, the ammonia hypothesis in the pathogenesis of HE is incomplete. Recently, it has been increasingly demonstrated that inflammation, including systemic inflammation, neuroinflammation and endotoxemia, acts in concert with ammonia in the pathogenesis of HE in cirrhotic patients. Meanwhile, a good number of studies have found that current therapies for HE, such as lactulose, rifaximin, probiotics and the molecular adsorbent recirculating system, could inhibit different types of inflammation, thereby improving the neuropsychiatric manifestations and preventing the progression of HE in cirrhotic patients. The anti-inflammatory effects of these current therapies provide a novel therapeutic approach for cirrhotic patients with HE. The purpose of this review is to describe the inflammatory mechanisms behind the etiology of HE in cirrhosis and discuss the current therapies that target the inflammatory pathogenesis of HE.
authors.affiliation: Ming Luo, Jian-Yang Guo, Department of Gastroenterology, Ningxia People's Hospital, Yinchuan 750021, Ningxia Hui Autonomous Region, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Luo
authors.affiliation: Ming Luo, Jian-Yang Guo, Department of Gastroenterology, Ningxia People's Hospital, Yinchuan 750021, Ningxia Hui Autonomous Region, China.
authors.forename: Jian-Yang
authors.initials: JY
authors.lastname: Guo
authors.affiliation: Ming Luo, Jian-Yang Guo, Department of Gastroenterology, Ningxia People's Hospital, Yinchuan 750021, Ningxia Hui Autonomous Region, China.
authors.forename: Wu-Kui
authors.initials: WK
authors.lastname: Cao
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D006801:Humans; D018836:Inflammation Mediators / Q000037:antagonists & inhibitors / Q000378:metabolism; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D018836:Inflammation Mediators
keywords: Hepatic encephalopathy; Inflammation; Pathogenesis; Treatment