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Plasma and cerebrospinal fluid amino acid patterns in hepatic encephalopathy

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Abstract

Plasma and cerebrospinal fluid amino acid levels were measured in 12 cirrhotic patients in grade 0 hepatic encephalopathy and 17 in grade 3–4 hepatic encephalopathy. In 5 of these patients amino acid determinations were performed during the evolution of the encephalopathy. No correlation was found between the degree of hepatic encephalopathy and the plasma amino acid imbalance. In the CSF of cirrhotic patients without encephalopathy, a significant increase was found in nearly all amino acids, including those known to not easily cross the blood-brain barrier; this suggests the presence of a nonspecific modification of the blood-brain barrier permeability. In patients with severe hepatic encephalopathy, the further increase only in cerebrospinal fluid aromatic amino acids and methionine levels suggests the presence of a selective stimulation of the neutral amino acid transport system across the blood-brain barrier. Finally, the good correlation between glutamine and the sum of neutral amino acids found in the cerebrospinal fluid only in the presence of encephalopathy supports the hypothesis that brain glutamine may stimulate neutral amino acid transport across the blood-brain barrier.

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Authors and Affiliations

  1. 3rd Department of Internal Medicine, University of Rome, Viale Pola, 23, 00198, Rome, Italy

    Antonia Cascino MD, Carlo Cangiano MD, Franco Fiaccadori MD, Florio Ghinelli MD, Manuela Merli MD, Guido Pelosi MD, Oliviero Riggio MD, Filippo Rossi Fanelli MD, Daria Sacchini MD, Marinella Stortoni MD &  Livio Capocaccia MD

  2. Division of Gastroenterology, University of L'Aquila, Italy

    Antonia Cascino MD, Carlo Cangiano MD, Franco Fiaccadori MD, Florio Ghinelli MD, Manuela Merli MD, Guido Pelosi MD, Oliviero Riggio MD, Filippo Rossi Fanelli MD, Daria Sacchini MD, Marinella Stortoni MD &  Livio Capocaccia MD

  3. Division of Infectious Diseases, Ospedali Riuniti di Parma, Italy

    Antonia Cascino MD, Carlo Cangiano MD, Franco Fiaccadori MD, Florio Ghinelli MD, Manuela Merli MD, Guido Pelosi MD, Oliviero Riggio MD, Filippo Rossi Fanelli MD, Daria Sacchini MD, Marinella Stortoni MD &  Livio Capocaccia MD

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  1. Antonia Cascino MD
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  2. Carlo Cangiano MD
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  3. Franco Fiaccadori MD
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  4. Florio Ghinelli MD
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  5. Manuela Merli MD
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  6. Guido Pelosi MD
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  7. Oliviero Riggio MD
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  8. Filippo Rossi Fanelli MD
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  9. Daria Sacchini MD
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  10. Marinella Stortoni MD
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  11. Livio Capocaccia MD
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Additional information

This work was supported by grant 500.6/Contr. 70/1743 Ministry of Health, Rome, Italy.

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Cascino, A., Cangiano, C., Fiaccadori, F. et al. Plasma and cerebrospinal fluid amino acid patterns in hepatic encephalopathy. Digest Dis Sci 27, 828–832 (1982). https://doi.org/10.1007/BF01391377

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  • DOI: https://doi.org/10.1007/BF01391377

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