Metabolic Brain Disease

, Volume 28, Issue 2, pp 183–186 | Cite as

Endothelial-astrocytic interactions in acute liver failure

  • A. R. Jayakumar
  • M. D. Norenberg
Original Paper


Brain edema and the subsequent increase in intracranial pressure are major neurological complications of acute liver failure (ALF), and swelling of astrocytes (cytotoxic brain edema) is the most prominent neuropathological abnormality in ALF. Recent studies, however, have suggested the co-existence of cytotoxic and vasogenic mechanisms in the brain edema associated with ALF. This review 1) summarizes the nature of the brain edema in humans and experimental animals with ALF; 2) reviews in vitro studies supporting the presence of cytotoxic brain edema (cell swelling in cultured astrocytes); and 3) documents the role of brain endothelial cells in the development of astrocyte swelling/brain edema in ALF.


Acute liver failure Astrocytes Blood-brain barrier Brain edema Endothelial cells Hepatic encephalopathy 



This work was supported by a Merit Review from the Department of Veterans Affairs and by National Institutes of Health grant DK063311. ARJ is supported by the Stanley J. Glaser Foundation grant.


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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Veterans Affairs Medical CenterMiamiUSA
  2. 2.Department of Pathology (D-33)University of Miami Miller School of MedicineMiamiUSA
  3. 3.Department of Biochemistry & Molecular BiologyUniversity of Miami Miller School of MedicineMiamiUSA

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