Abstract
Encephalopathy is a severe and common complication of cirrhosis, including alcoholic cirrhosis, but its pathogenesis is not fully understood. Several new theories have been proposed, and many have emphasized the importance of plasma amino acids. Recent studies have called into question the hypothesis that the ratio of aromatic to branched-chain amino acids in plasma is the key abonormality in this disorder.
Keywords
- Hepatic Encephalopathy
- Plasma Amino Acid
- Hepatic Coma
- Idiopathic Portal Hypertension
- Chronic Alcohol Consumption
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Aguirre, A. L., Yoshimura, N., Westman, T., and Fischer, J. E., 1974, Plasma α-amino acids in dogs with two experimental forms of liver damage, J. Surg. Res. 16:339–345.
Branchey, L., Shaw, S., and Lieber, C. S., 1981, Ethanol impairs tryptophan transport into the brain and depresses serotonins Life Sci. 29:2751–2755.
Faraj, B. A., Bowen, P. A., Isaacs, J. W., and Rudman, D., 1976, Hypertyraminemia in cirrhotic patients, N. Engl. J. Med. 294:1360–1364.
Faraj, B. A., Fulwider, J. T., Rypins, E. B., Nordlinger, B., Ivey, G. L., Jansen, R. D., Ali, F. M., Camp, V. M., Kutner, M., Schmidt, F., and Rudman, D., 1979, Tyramine kinetics and metabolism in cirrhosis, J. Clin. Invest. 64:413–420.
Fernstrom, J. D., and Wurtman, R. J., 1972, Brain serotonin content: Physiological regulation by plasma neutral amino acids, Science 178:414–416.
Finkelstein, J. D., and Kyle, W. E., 1968, Ethanol effects on methionine metabolism in rat liver, Proc. Soc. Exp. Biol. Med. 129:497–501.
Finkelstein, J. D., Cello, J. P., and Kyle, W. E., 1974, Ethanol induced changes in methionine metabolism in rat liver, Biochem. Biophys. Res. Commun. 61:525–531.
Fischer, J. E., Yoshimura, N., Aguirre, A., James, J. H., Cummings, M. G., Abel, R. M., and Deindorfer, F., 1974, Plasma amino acids in patients with hepatic encephalopathy: Effects of amino acid infusions, Am. J. Surg. 127:40–47.
Fischer, J. E., Funovics, J.M., Aguirre, A., James, J. H., Keane, J. M., Wesdorp, R. I. C., Yoshimura, N., Westman, T., 1975, The role of plasma amino acids in hepatic encephalopathy, Surgery 78:276–290.
Fischer, J. E., Rosen, H. M., Ebeid, A. M., James, J. H., Keane, J. M., and Soeters, P. B., 1976, The effect of normalization of plasma amino acids on hepatic encephalopathy in man, Surgery 80:77–91.
Holt, L. E., Snyderman, S. E., Norton, P. M., and Roitman, E., 1968, The plasma aminogram as affected by protein intake, in: Protein Nutrition and Free Amino Acid Patterns (J. H. Leathern, ed.), pp. 32–39, Rutgers University Press, New Brunswick, New Jersey.
Hsu, J. M., 1979, Ethanol comsumption and free amino acids of rat plasma and liver, in: NIAAA Research Monograph 2: Alcohol and Nutrition (T.-K. Li, S. Schenker, and L. Lumeng, eds.), pp. 289–293, DHEW Publication (ADM) 79–780, U.S. Government Printing Office, Washington.
Iber, F. L., Rosen, H., Levenson, S. M., and Chalmers, T. C., 1957, Plasma amino acids in patients with liver failure, J. Lab. Clin. Med. 50:417–425.
Ishii, H., Kanno, T., Shigeta, Y., Takagi, S., Yasurakka, S., Kano, S., Takeshita, E., and Tsuchiya, M., 1976, Hepatic gamma glutamyl transpeptidase (GGTP) activity: Its activation by chronic ethanol administration, Gastroenterology 71:913.
Iwasaki, Y., Sato, H., Ohkubo, A., Sanjo, T., Futagawa, S., Sugiura, M., and Tsuji, S., 1980, Effect of spontaneous portal-systemic shunting on plasma insulin and amino acid concentrations, Gastroenterology 78:677–683.
James. H. J., Hodgman, J. M., Funovics, J. M., Yoshimura, N., and Fischer, J. E., 1976, Brain tryptophan, plasma free tryptophan and distribution of plasma neutral amino acids, Metabolism 25:471–476.
Levine, R. J., and Conn, H. O., 1967, Tyrosine metabolism in patients with liver disease, J. Clin. Invest. 46:2012–2020.
Morgan, M. Y., Milson, J. P., and Sherlock, S., 1978, Plasma ratio of valine, leucine and isoleucine to phenylalanine and tyrosine in liver disease, Gut 19:1068–1073.
Ning, M., Lowenstein, L. M., and Davidson, C. S., 1967, Serum amino acid concentrations in alcoholic hepatitis, J. Lab. Clin. Med. 70:554–562.
Ono, J., Hutson, D. G., Dombro, R. S., Levi, J. U., Livingstone, A., and Zeppa, R., 1978, Tryptophan and hepatic coma, Gastroenterology 74:196–200.
Rosen, H. M., Yoshimura, N., Hodgman, J. M., and Fischer, J. E., 1977, Plasma amino acid patterns in hepatic encephalopathy of differing etiology, Gastroenterology 72:438–488.
Shaw, S., and Lieber, C. S., 1975, Plasma amino acids in alcoholic liver injury: Contrast with protein malnutrition, Clin. Res. 23:459.
Shaw, S., and Lieber, C. S., 1978, Plasma amino acid abnormalities in the alcoholic; respective role of alcohol, nutrition and liver injury, Gastroenterology 74:677–682.
Shaw, S., and Lieber, C. S., 1980, Increased hepatic production of alpha amino-n-butyric acid after chronic alcohol consumption in rats and baboons, Gastroenterology 78:108–113.
Shaw, S., and Lieber, C. S., 1980, Mechanism of increased gamma glutamyl transpeptidase after chronic alcohol consumption: Hepatic microsomal induction rather than dietary imbalance, Substance Alc. Actions Misuse 1:423–428.
Shaw, S., Stimmel, B., and Lieber, C. S., 1976, Plasma alpha amino-n-butyric acid to leucine ratio: An empirical biochemical marker of alcoholism, Science 194:105710–58.
Shaw, S., Worner, T. M., Borysow, M. F., Schmitz, R. E., and Lieber C. S., 1979, Detection of alcoholic relapse: Comparative diagnostic value of MCV, GGTP and AANB, Alcoholism: Clin. Exp. Res. 3:297–301.
Sherwin, R., Joshi, P., Hendler, R., Felig, P., and Conn, H., 1974, Hyperglucagonemia in Laennec’s cirrhosis, N. Engl. J. Med. 290:239–242.
Sies, H., Koch, O. R., Martino, E., and Boveris, A., 1979, Increased biliary glutathione disulfide release in chronically ethanol-treated rats, FEBS Lett. 103:287–290.
Soeters, P. B., and Fischer, J. E., 1976, Insulin, glucagon, aminoacid imbalance and hepatic encephalopathy, Lancet 2:880–882.
Stanko. R. T., Morse, E. L., and Adibi, S. A., 1979, Prevention of effects of ethanol on amino acid concentrations in plasma and tissues by hepatic lipotropic factors in rats, Gastroenterology 76:132–138.
Swendseid, M. E., Tuttle, S. G., Figueroa, W. S., Mulcare, D., Clark, A. J., and Massey, F. J., 1966, Plasma amino acid levels of men fed diets differing in protein content. Some observations with valine-deficient diets, J. Nutr. 88:239–248.
Swendseid, M. E., Yamada, C., Vinyard, E., and Figueroa, W. G., 1968, Plasma amino acid levels in young subjects receiving diets containing 14 or 3.5 grams nitrogen per day, Am. J. Clin. Nutr. 21:1381–1383.
Teschke, R., Brand, A., and Strohmeyer, G., 1977, Induction of hepatic microsomal gamma-glutamyltransferase activity following chronic alcohol consumption, Biochem. Biophys. Res. Commun. 75:718–724.
Zinneman, H. H., Seal, U. S., and Doe, R. P., 1969, Plasma and urinary amino acids in Laennec’s cirrhosis, Am. J. Dig. Dis. 14:118–126.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1982 Plenum Publishing Corporation
About this chapter
Cite this chapter
Shaw, S., Lieber, C.S. (1982). Alcohol, Amino Acids, and Encephalopathy. In: Freinkel, N. (eds) Contemporary Metabolism. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-4187-1_5
Download citation
DOI: https://doi.org/10.1007/978-1-4684-4187-1_5
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4684-4189-5
Online ISBN: 978-1-4684-4187-1
eBook Packages: Springer Book Archive