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An upper gastrointestinal (GI) bleed in cirrhotic patients has been hypothesised to induce catabolism due to the absence of the essential branched chain amino acid (BCAA) isoleucine and an abundance of the BCAA leucine in haemoglobin. We tested whether an upper GI bleed produces hypoisoleucinemia via BCAA antagonism and impairs protein synthesis.Isoleucine turnover and oxidation was studied in 5 metabolically...
The presence of hepatic encephalopathy, whether it occurs in patients with acute or chronic liver injury, indicates liver failure and is a serious complication. The pathogenesis of hepatic encephalopathy remains elusive, but the importance of ammonia, the glutamine–glutamate cycle, the involvement of other putative humoral factors and receptors as well as the importance of astrocytes are described...
This study tests the hypothesis that administration of an oral amino acid load mimicking hemoglobin in patients with cirrhosis of the liver causes deterioration in neuropsychological function and a reduction in regional cerebral perfusion. Eight overnight fasted, metabolically stable cirrhotic patients with no evidence of overt hepatic encephalopathy were studied prior to and 4 h after simulating...
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