Advertisement

Long Term Dietary Supplement with Branched Chain Amino Acids: A New Approach in the Prevention of Hepatic Encephalopathy: Results of a Controlled Study in Cirrhotics with Porto-Caval Anastomosis

  • O. Riggio
  • C. Cangiano
  • A. Cascino
  • M. Merli
  • M. Stortoni
  • F. Rossi Fanelli
  • V. Ziparo
  • M. Anzà
  • R. Lupino

Abstract

Recurrent episodes of hepatic encephalopathy (HE) frequently occur in patients with cirrhosis of the liver especially after surgical portal systemic anastomosis.l The prevention of these recurrent episodes of HE is based on neomycin, purging of the gastrointestinal tract, lactulose and restriction of protein intake.2

Keywords

Hepatic Encephalopathy Cirrhotic Patient Branch Chain Amino Acid Plasma Amino Acid Plasma Ammonia 
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.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    A. E. Read, S. Sherlock, J. Laidlow, The neuropsychiatric syndromes associated with chronic liver disease and extensive portal-systemic collateral circulation, Q. J. Med. 36: 135 (1967).Google Scholar
  2. 2.
    H. O. Conn and M. M. Lieberthal, Hepatic Coma Syndromes and Lactulose.“The Williams & Wilkins Co. Baltimore (1979).Google Scholar
  3. 3.
    E. Mezey, Liver disease and nutrition, Gastroenterology 74: 770 (1978).PubMedGoogle Scholar
  4. 4.
    A. Cascino, C. Cangiano, V. Calcaterra, F. Rossi Fanelli, and L. Capocaccia, Plasma amino acids imbalance in patients with liver diseases Am. J. Dig. Dis. 23: 591 (1978).PubMedCrossRefGoogle Scholar
  5. 5.
    J. E. Fischer, J. M. Funovics, A. Aguirre, J. H. James, J. M. Keane, R. I. C. Wesdorp, N. Yoshimura, and T. Westman, The role of plasma amino acids in hepatic encephalopathy, Surgery 78: 276 (1975).PubMedGoogle Scholar
  6. 6.
    J. E. Fischer, H. M. Rosen, A. M. Ebeid, J. H. James, J. M. Flane, and P. B. Soeters, The effect of normalization of plasma amino acids on hepatic encephalopathy in man, Surgery 80: 77 (1976).PubMedGoogle Scholar
  7. 7.
    L. Capocaccia, V. Calcaterra, C. Cangiano, A. Cascino, F. Fiaccadori, S. Gentile, F. Ghinelli, G. Pelosi, 0. Riggio, F. Rossi Fanelli, D. Sacchini, and G. Giunchi, Therapeutic effect of branched chain amino acids in hepatic encephalopathy. A preliminary study, in: “Medical and Surgical Problems of Portal Hypertension M. J. Orloff, S. Stipa, and V. Ziparo, eds., Academic Press, New York (1980).Google Scholar
  8. 8.
    F. Rossi Fanelli, 0. Riggio, C. Cangiano, A. Cascino, D. De Conciliis, M. Merli, M. Stortoni, and G. Giunchi (Coordinator L. Capocaccia). Branched-chain amino acids vs lactulose in the treatment of hepatic coma. A controlled study, Dig. Dis. and Sci. 27: 865 (1982).CrossRefGoogle Scholar
  9. 9.
    A. F. Attili, D. Autizi, L. Capocaccia, S. Costantini,and F. Cotta Ramusino, Rapid determination of plasma ammonia using an ion specific electrode, Biochem. Med. 14: 109 (1975).Google Scholar
  10. 10.
    D. E. Duggan and S. Udenfriend, Spectrofluorimetric determination of tryptophan in plasma and of tyrosine and tryptophan in protein hydrolysate, J. Biol. Chem. 223: 313 (1956).PubMedGoogle Scholar
  11. 11.
    H. Freund, H. C. Hoover, S. Atamian, and J. E. Fischer, Infusion of branched chain amino acids in post-operative patients, Am. J. Surg. 190: 18 (1979).Google Scholar
  12. 12.
    F. Rossi Fanelli, M. Angelico, C. Cangiano, A. Cascino, R. Capocaccia, D. De Conciliis, 0. Riggio,and L. Capocaccia, Effect of glucose and/or branched chain amino acid infusion in plasma amino acid imbalance in chronic liver failure, J. P. E. N. 5: 414 (1981).Google Scholar
  13. 13.
    F. Rossi Fanelli, H. Freund, R. Krause, A. R. Smith, J. H. James, S. Castorina-Ziparo, and J. E. Fischer, Induction of coma in normal dogs by the infusion of aromatic amino acids and its prevention by the addition of branched chain amino acids, Gastroenterology 83: 664 (1982).Google Scholar
  14. 14.
    H. Freund, N. Yoshimura,and J. E. Fischer, Long-term oral branched chain amino acid therapy in chronic hepatic encephalopathy, JAMA 242: 347 (1979).Google Scholar
  15. 15.
    M. Walser and J. R. Williamson, Metabolism and clinical implications of branched-chain amino and ketoacids, Elsevier/ North Holland (1981).Google Scholar
  16. 16.
    D. Horst, N. Grace, H. 0. Conn, E. Schiff, S. Schenker, A. Viteri, D. Law, and C.E. Atterbury, A double-blind randomized comparison of dietary protein and an oral branched chain amino acid (BCAA) solution in cirrhotic patients with chronic portal-systemic encephalopathy, Clinical Research 641A (1982).Google Scholar
  17. 17.
    G. Marchesini, C. Dondi, and M. Zoli, Insuccesso nel trattamento dell’encefalopatia epatica cronica con aminoacidi a catena ramificata per via orale, Il Fegato 27: 51 (1981).Google Scholar

Copyright information

© Plenum Press, New York 1984

Authors and Affiliations

  • O. Riggio
    • 1
  • C. Cangiano
    • 1
  • A. Cascino
    • 1
  • M. Merli
    • 1
  • M. Stortoni
    • 1
  • F. Rossi Fanelli
    • 1
  • V. Ziparo
    • 2
  • M. Anzà
    • 2
  • R. Lupino
    • 2
  1. 1.III Clinica MedicaUniversity of RomeItaly
  2. 2.IV Patologia ChirurgicaUniversity of RomeItaly

Personalised recommendations