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Hepatic Encephalopathy, Hyperammonemia, and Ammonia Toxicity pp 79–88Cite as

Portal-Systemic Encephalopathy: a Disorder of Multiple Neurotransmitter Systems

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Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 368))

Abstract

Portal-Systemic Encephalopathy (PSE) is a serious complication of chronic liver disease; portal-systemic shunting rather than hepatic dysfunction appears to be the primary abnormality in PSE.

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References

  1. Hindfelt B., Plum F., Duffy T.E., 1977, Effects of acute ammonia intoxication on cerebral metabolism in rats with portacaval shunts, J. Clin. Invest. 59:386–396.

    Article  PubMed  CAS  Google Scholar 

  2. Fitzpatrick S.M., Behar K.L. and Shulman R.G., 1989, In vivo NMR spectroscopy studies of cerebral metabolism in rats after portacaval shunting. In “Hepatic Encephalopathy: Pathophysiology and Treatment” (R.F. Butterworth and G. Pomier Layrargues, eds.), Humana Press, pp. 177–187.

    Google Scholar 

  3. Hahn M., Massen O., Nencki M., Pavlov J., 1893, Die Ecksche Fistel zwischen der unteren Hohlvene und der Pfortader und ihre Folgen für den Organismus, Arch. Exp. Path. Pharmakol. 32:161–170.

    Article  Google Scholar 

  4. Matthews S.W., 1922, Ammonia, a causative factor in meat poisoning in Eck fistula dogs, Am. J.Physiol. 59:459–460.

    CAS  Google Scholar 

  5. Giguère J.F. and Butterworth R.F., 1984, Amino acid changes in regions of the CNS in relation to function in experimental portal-systemic encephalopathy, Neurochem. Res. 9:1309–1321.

    Article  PubMed  Google Scholar 

  6. Raabe W., 1987, Synaptic transmission in ammonia intoxication, Neurochem. Pathol. 6:145–166.

    Article  PubMed  CAS  Google Scholar 

  7. Butterworth R.F., Girard G., Giguère J.F., 1988, Regional difference in the capacity of ammonia removal by brain following portacaval anastomosis, J. Neurochem. 51:486–490.

    Article  PubMed  CAS  Google Scholar 

  8. Szerb J.C. and Butterworth R.F., 1992, Effect of ammonium ions on synaptic transmission in the mammalian central nervous system, Prog. Neurobiol. 39:135–153.

    Article  PubMed  CAS  Google Scholar 

  9. Fan P., Lavoie J., Le N.L.O., Szerb J.C., Butterworth R.F., 1990, Neurochemical and electrophysiological studies on the inhibitory effect ol ammonium ions on synaptic transmission in slices of rat hippocampus: evidence for a postsynaptic action, Neurosci. 37:327–324.

    Article  CAS  Google Scholar 

  10. Norenberg M.D., Mozes L.W., Papendick R.E., Norenberg L.0.B., 1985, Effect of ammonia on glutamate, GABA and rubidium uptake by astrocytes, Ann. Neurol. 18:149.

    Google Scholar 

  11. Mena E.E. and Cotman C.W., 1985, Pathologic concentrations of ammonium ions block L-glutamatc uptake. Exp. Neurol. 59:259– 263.

    Article  Google Scholar 

  12. Schmidt W., Wolf G., Grungreiff K., Meier M., Reum T., 1990, Hepatic encephalopathy influences high-affinity uptake of transmitter glutamate and aspartate into the hippocampal formation, Metab. Brain Dis. 5:19–31.

    Article  PubMed  CAS  Google Scholar 

  13. Butterworth R.F., Le O., Lavoie J., Szerb J.C., 1991, Effect of portacaval anastomosis on electrically-stimulated release of glutamate from rat hippocampal slices. J. Neurochem. 56:1481–1484.

    Article  PubMed  CAS  Google Scholar 

  14. Moroni F., Lombardi G., Moneti G., Cortesini C., 1983, The release and neosynthesis of glutamic acid are increased in experimental models of hepatic encephalopathy, J. Neurochem. 40:850–854.

    Article  PubMed  CAS  Google Scholar 

  15. Tossman U., Delin A., Eriksson L.S., Ungerstedt U., 1987, Brain cortical amino acids measured by intracerebral dialysis in portacaval shunted rats, Neurochem. Res. 12:265–269.

    Article  PubMed  CAS  Google Scholar 

  16. Peterson C, Giguère J.F., Cotman C.W., Butterworth R.F., 1990, Selective loss of N-methyl-D-aspartate-sensitive L-3H-glutamate binding sites in rat brain following portacaval anastomosis, J. Neurochem. 55:386–390

    Article  PubMed  Google Scholar 

  17. Rao V.L.R., Murthy C.R.K., Butterworth R.F., 1992, Glutamatergic synaptic dysfunction in hyperammonemic syndromes, Metab. Brain Dis. 7:1–20.

    Article  PubMed  CAS  Google Scholar 

  18. Moroni E, Lombardi G., Carla V., Pellegrini D., Carassale O.L., Cortesini C., 1986, Content of quinolinic acid and other tryptophan metabolites increases in brain regions of rats used as experimental models of hepatic encephalopathy, J. Neurochem. 46:869–874.

    Article  PubMed  Google Scholar 

  19. Marcaida G, Felipo V, Hermenegildo C, Minana M-D, and Grisolia S., 1992, Acute ammonia toxicity is mediated by the NMDA type of glutamate receptors. FEBS Lett, 296:67–68.

    Article  PubMed  CAS  Google Scholar 

  20. Young S.N., Lal S., Feldmuller F., Aranoff A., Martin J.B., 1975, Relationships between tryptophan in serum and CSF and 5-hydroxyindoleacetic acid in CSF of man: effects of cirrhosis of the liver and probenecid administration, J. Neurol. Neurosurg. Psychiat. 38:322–330.

    Article  PubMed  CAS  Google Scholar 

  21. Bergeron M., Reader T.A., Pomier Layrargues G., Butterworth R.E, 1989, Monoamines and metabolites in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy, Neurochem. Res. 14:853– 849.

    Article  PubMed  CAS  Google Scholar 

  22. Bergeron M., Swain MS., Reader T.A., Grondin L., Butterworth R.F., 1990, Effect of ammonia on brain serotonin metabolism in relation to function in the portacaval shunted rat, J. Neurochem. 55:222–229.

    Article  PubMed  CAS  Google Scholar 

  23. Bachmann C. and Colombo JP., 1984, Increase of trytophan and 5-hydroxyindoleacetic acid in the brain in ornithine carbamoyl transferase deficient sparse-fur mice. Pediat. Res. 18:372–375.

    Article  PubMed  CAS  Google Scholar 

  24. Bengtsson F., Bugge M., Johansen K.H., Butterworth R.F., 1991, Brain tryptophan hydroxylation in the portacaval shunted rat: a hypothesis for the regulation of serotonin turnover in vivo, J. Neurochem. 56:1069–1074.

    Article  PubMed  CAS  Google Scholar 

  25. W. Raghavendra Rao V.L., Giguère J.-F., Pomier Layrargues G., Butterworth R.F., 1993,Increased activities of MAOA and MAOB in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy, Brain Res. 621:349–352.

    Article  Google Scholar 

  26. Raghavendra Rao V.L. and Butterworth R.F., 1994, Alterations of 3H-8H-DPAT and 3H-ketanserin binding sites in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy, Neurosci. Lett. (in press).

    Google Scholar 

  27. Vorobioff J., Garcia-Tsao G., Groszmann R., Aceves G., Picabea E., Villavicencio R.,Hernandez-Ortiz, J., 1988, Long-term hemodynamic effects of ketanserin, a 5-hydroxytryptamine blocker, in portal hypertensive patients, Hepatology 9:88–91.

    Article  Google Scholar 

  28. Batshaw M.L., Heyes M., Diali S., Rorke L. and Robinson M.B., 1990, Tryptophan (Trp),Quinolinate (Quin) and serotonin (5HT): 1. Alterations in children with hyperammonemia, Soc. Neurosci. Abs.

    Google Scholar 

  29. Young S.N. and Lal S., 198O, CNS tryptamine metabolism in hepatic coma, J. Neural. Transm.47:153–161.

    Article  PubMed  CAS  Google Scholar 

  30. Mousseau D.D., 1993, Tryptamine, a metabolic of tryptophan implicated in various neuropyschiatric disorders, Metab. Brain Dis., 8:1–44.

    Article  PubMed  CAS  Google Scholar 

  31. Mousseau D.D., 1994, Region-selective decreases in densities of 3H-tryptamine binding sites in autopsied brain tissue from cirrhotic patients witb hepatic encephalopathy, J. Neurochem. (in press)

    Google Scholar 

  32. Conn H.O., 1988, The hepatic encephalopathies. In: Conn HO, Bircher J., Eds. Hepatic Encephalopathy: Management with Lactulose and Related Carbohydrates. East-Lansing MI: Medi-Press, pp 3–14.

    Google Scholar 

  33. Lunzer M., James I.M., Weinman J., Sherlock S., 1974, Treatment of chronic hepatic encephalopathy with levodopa, Gut 15:555–561.

    Article  PubMed  CAS  Google Scholar 

  34. Morgan M.Y., Jakobovits A.W., James I.M., Sherlock S., 1980, Successful use of bromocriptine in the treatment of chronic hepatic encephalopathy, Gastroenterology 78:663–670.

    PubMed  CAS  Google Scholar 

  35. Uribe M., Farca A., Marquez M.A., Garcia-Ramos G., Guevara L., 1979, Treatment of chronic portal systemic encephalopathy with bromocriptine, Gastroenterology 76:1347–1351.

    PubMed  CAS  Google Scholar 

  36. Michel H., Solere M., Granier P., Cauvet G., Bali J.P., Bellet-Hermann H., 198O, Treatment of cirrhotic hepatic encephalopathy with L-DOPA. A controlled trial, Gastroenterology 79:207–211.

    PubMed  CAS  Google Scholar 

  37. Mousseau D.D., Perney P., Pomier Layrargues G., Butterworth R.P., 1993, Selective loss of pallidal dopamine D2 receptor density in hepatic encephalopathy, Neurosci. Lett. 162:192–196.

    Article  PubMed  CAS  Google Scholar 

  38. Schafer D.F. and Jones E.A., 1982, Hepatic encephalopathy and the γ-aminobutyric acid system,Lancet 1:18–20

    Article  PubMed  CAS  Google Scholar 

  39. Baraldi M, Zeneroli M.L, Ventura E., Penne A., Pinelli G., Ricci P., Santi M., 1984,Supersensitivity of benzodiazepine receptors in hepatic encephalopathy due to fulminant hepatic failure in thet rat: reversal by a benzodiazepine antagonist, Clin. Sci. 61:167–175.

    Google Scholar 

  40. Roy S., Pomier Layrargues G., Butterworth R.F., Huet P.M, 1988, Hepatic encephalopathy in cirrhotic and portacaval shunted dogs: lack of changes in brain GABA uptake, brain GABA levels and brain glutamic acid decarboxylase activity aad brain postsynaptic GABA receptors, Hepatology 8:845–849.

    Article  PubMed  CAS  Google Scholar 

  41. Lavoie J., Giguère J.F., Pomier Layrargues G., Butterworth R.F., 1987, Amino acid changes in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy, J. Neurochem. 49:692–697.

    Article  PubMed  CAS  Google Scholar 

  42. Lavoie J., Giguère J.F., Pomier Layrargues G., Butterworth R.F., 1987, Activities of neuronal andastrocytic marker enymes in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy, Metab. Brain Dis. 2:283–290.

    Article  PubMed  CAS  Google Scholar 

  43. Butterworth R.F., Lavoie J., Giguère J.F., Pomier Layrargues G., 1988, Affinities and densities of GABA-A receptors and of central benzodiazepine. receptors are unchanged in autopsied brain tissue from cirrhotic patients with hepatic encephalopathy, Hepatology 8:1084–1088.

    Article  PubMed  CAS  Google Scholar 

  44. Olasmaa M., Rothstein J.D., Guidotti A., Weber R.J., Paul S.M., Spector S., Zeneroli M.L.,Baraldi M., Costa E., 1990, Endogenous benzodiazepine receptor ligands in human and animal hepatic encephalopathy, J. Neurochem. 55:2015–2023.

    Article  PubMed  CAS  Google Scholar 

  45. Mans A.M., Kukulka K.M., McAvoy K.J. and Rokosz N.C., 1992, Regional distribution and kinetics of three sites on the GABAA receptor: lack of effect of portacaval shunting, J. Cerebr. Blood Flow and Metab.12:334–3461.

    Article  CAS  Google Scholar 

  46. Bansky G., Meier P.J., Riedere E., Walser H., Ziegler W.H., Schmid M., 1989, Effects of the benzodiazepine receptor antagonist flumazenil in hepatic encephalopathy in humans, Gastroenterology 97:744–750.

    PubMed  CAS  Google Scholar 

  47. Klotz U. and Walker S., 1989, Flumazenil and hepatic encephalopathy, Lancet 1:155–156.

    Article  PubMed  CAS  Google Scholar 

  48. Van der Rijt C.C.D., Schalm S.W., Meulstee J., Stijnen T., 1989, Flumazenil therapy for hepatic encephalopathy: a double-blind cross-over study, Hepatology 10:590 (abstract).

    Google Scholar 

  49. Pomier Layrargues G., Giguère J.F., Lavoie J., Gagnon S., D’Amour M., Caillé G., Wells J. and Butterworth R.F., 1994, Efficacy of Ro15–1788 in cirrhotic patients with hepatic coma: results of a randomized double-blind placebo-controlled crossover trial, Hepatology 19:32–37.

    Google Scholar 

  50. Rudman D., Sewell C.W. and Ansley J.D.,1977, Deficiency of carnitine in cachectic cirrhotic patients, J. Clin. Invest. 60:716–623.

    Article  PubMed  CAS  Google Scholar 

  51. Hearn T.J., Coleman A.E., Lai J.C.K., Griffith O.W. and Cooper A.J.L., 1989, Effect of orally administered L-carnitine on blood ammonia and L-carnitine concentrations in portacaval shunted rats, Hepatology 10:822–828.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Neuroscience Research Unit. Hôpital Saint-Luc, University of Montreal, Montreal, Quebec, Canada, H2X 3J4

    Roger F. Butterworth

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  1. Roger F. Butterworth
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Editor information

Editors and Affiliations

  1. Instituto de Investigaciones Citologicas de la F. I. B., Valencia, Spain

    Vicente Felipo  & Santiago Grisolia  & 

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Butterworth, R.F. (1994). Portal-Systemic Encephalopathy: a Disorder of Multiple Neurotransmitter Systems. In: Felipo, V., Grisolia, S. (eds) Hepatic Encephalopathy, Hyperammonemia, and Ammonia Toxicity. Advances in Experimental Medicine and Biology, vol 368. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1989-8_8

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  • DOI: https://doi.org/10.1007/978-1-4615-1989-8_8

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-5820-6

  • Online ISBN: 978-1-4615-1989-8

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