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Metabolic Brain Disease

, Volume 25, Issue 1, pp 3–9 | Cite as

Evidence for oxidative/nitrosative stress in the pathogenesis of hepatic encephalopathy

  • Chantal Bemeur
  • Paul Desjardins
  • Roger F. Butterworth
Original Paper

Abstract

Hepatic encephalopathy (HE) is a serious complication of liver failure. HE manifests as a series of neuropsychiatric and neuromuscular symptoms including personality changes, sleep abnormalities, asterixis and muscle rigidity progressing through stupor to coma. The pathophysiologic basis of HE remains unclear. There is general agreement that ammonia plays a key role. In recent years, it has been suggested that oxidative/nitrosative stress constitutes part of the pathophysiologic cascade in HE. Direct evidence for oxidative/nitrosative stress in the pathogenesis of HE has been demonstrated in experimental animal models of acute or chronic liver failure. However, evidence from studies in HE patients is limited. This review summarizes this evidence for a role of oxidative/nitrosative stress in relation to ammonia toxicity and to the pathogenesis of HE.

Keywords

Hepatic encephalopathy Oxidative stress Antioxidants Liver failure 

Abbreviations

HE

hepatic encephalopathy

ALF

acute liver failure

eNOS

endothelial nitric oxide synthase

HO-1

heme oxygenase-1

TAA

thioacetamide

SOD

superoxide dismutase

MPT

mitochondrial permeability transition

PTP

permeability transition pore

NAC

n-acetylcysteine

iNOS

inducible nitric oxide synthase

nNOS

neuronal nitric oxide synthase

NMDAr

n-methyl-d-aspartic acid receptors

GS

glutamine synthetase

MSO

methionine sulfoximine

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Chantal Bemeur
    • 1
  • Paul Desjardins
    • 1
  • Roger F. Butterworth
    • 1
    • 2
  1. 1.Neuroscience Research UnitHôpital Saint-Luc (CHUM) University of MontrealMontrealCanada
  2. 2.Neuroscience Research UnitSt-Luc Hospital (CHUM), University of MontrealMontrealCanada

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