ISSN:
1573-7365
Keywords:
Portal-systemic Encephalopathy
;
Hepatic Encephalopathy
;
Ammonia
;
L-ornithine-L-aspartate
;
Glutamine synthesis
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Strategies aimed at the lowering of blood ammonia remain the treament of choice in portal-systemic encephalopathy (PSE). L-ornithine-L-aspartate (OA) has recently been shown to be effective in the prevention of ammonia-precipitated coma in humans with PSE. These findings prompted the study of mechanisms of the protective effect of OA in portacaval-shunted rats in which reversible coma was precipitated by ammonium acetate administration (3.85 mmol/kg i.p.). OA infusions (300 mg/kg/h, i.v) offered complete protection in 12/12 animals compared to 0/12 saline-infused controls. This protective effect was accompanied by significant reductions of blood ammonia, concomitant increases of urea production and significant increases in blood and cerebrospinal fluid (CSF) glutamate and glutamine. Increased CSF concentrations of leucine and alanine also accompanied the protective effect of OA. These findings demonstrate the therapeutic efficacy of OA in the prevention of ammonia-precipitated coma in portacaval-shunted rats and suggest that this protective effect is both peripherally-mediated (increased urea and glutamine synthesis) and centrally-mediated (increased glutamine synthesis).
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1020613314572
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