Clinical trial: oral zinc in hepatic encephalopathy

Takuma, Yoshitaka; Nouso, Kazuhiro; Makino, Yasuhiro; Hayashi, Miho; Takahashi, Hiroshi

doi:10.1111/j.1365-2036.2010.04448.x

Cited by 112 publications

(78 citation statements)

References 39 publications

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“…Oral zinc supplementation is effective in hepatic encephalopathy and consequently improves patients health-related quality of life [72] . Recent research further confirms that treatment of HE with oral L-ornithine-L-aspartate in cirrhotic patients considerably improved health-related quality of life [73] . Douglas et al have contraindicated the use of tetracyclines and antituberculosis drugs in patients with liver failure [74] .…”

Section: Antibiotic Regimen With Precautionmentioning

confidence: 76%

Indications of antibiotic prophylaxis in dental practice–Review

Ramu

Padmanabhan

2012

Asian Pacific Journal of Tropical Biomedicine

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Section: Antibiotic Regimen With Precautionmentioning

confidence: 76%

Indications of antibiotic prophylaxis in dental practice–Review

Ramu

Padmanabhan

2012

Asian Pacific Journal of Tropical Biomedicine

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“…Zinc is a cofactor for both GS and acetyl transcarboxylase; therefore deficiency can lead to increased circulating ammonia levels through decreased metabolism (Marchesini et al 1996;Yoshida et al 2001). Oral zinc supplementation alone had significant improvement on the incidence and severity of HE but clinical trials have yet to be performed (Takuma et al 2010). Conversely, excess manganese deposition in the basal ganglia and globus pallidum has been proposed to induce or enhance encephalopathic symptoms in CLD (Maffeo et al 2014;Pomier-Layrargues et al 1995).…”

Section: Therapeutic Strategies Targeting the Gut-liver-brain Axismentioning

confidence: 99%

Clinical science workshop: targeting the gut-liver-brain axis

et al. 2015

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A clinical science workshop was held at the ISHEN meeting in London on Friday 11th September 2014 with the aim of thrashing out how we might translate what we know about the central role of the gut-liver-brain axis into targets which we can use in the treatment of hepatic encephalopathy (HE). This review summarises the integral role that interorgan ammonia metabolism plays in the pathogenesis of HE with specific discussion of the roles that the small and large intestine, liver, brain, kidney and muscle assume in ammonia and glutamine metabolism. Most recently, the salivary and gut microbiome have been shown to underpin the pathophysiological changes which culminate in HE and patients with advanced cirrhosis present with enteric dysbiosis with small bowel bacterial overgrowth and translocation of bacteria and their products across a leaky gut epithelial barrier. Resident macrophages within the liver are able to sense bacterial degradation products initiating a pro-inflammatory response within the hepatic parenchyma and release of cytokines such as tumour necrosis factor alpha (TNF-α) and interleukin-8 into the systemic circulation. The endotoxemia and systemic inflammatory response that are generated predispose both to the development of infection as well as the manifestation of covert and overt HE. Co-morbidities such as diabetes and insulin resistance, which commonly accompany cirrhosis, may promote slow gut transit, promote bacterial overgrowth and increase glutaminase activity and may need to be acknowledged in HE risk stratification assessments and therapeutic regimens. Therapies are discussed which target ammonia production, utilisation or excretion at an individual organ level, or which reduce systemic inflammation and endotoxemia which are known to exacerbate the cerebral effects of ammonia in HE. The ideal therapeutic strategy would be to use an agent that can reduce hyperammonemia and reduce systemic inflammation or perhaps to adopt a combination of therapies that can address both.

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“…Recently, lactulose and/or probiotic therapy have been shown to decrease serum ammonia levels [95]. Additionally, zinc supplementation is also effective in improving ammonia metabolism [96,97].…”

Section: Nutrition Therapy For Lc With a History Of Hepaticmentioning

confidence: 99%

A 12-week Double-blind Randomized Clinical Trial Of Vitamin D3 Supplementation On Body Fat Mass In Healthy Overweight And Obese Women

Coles¹

2013

Clinical Nutrition

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The dietary intake of patients with nonalcoholic fatty liver disease (NAFLD) is generally characterized by high levels of carbohydrate, fat, and/or cholesterol, and these dietary patterns influence hepatic lipid metabolism in the patients. Therefore, careful investigation of dietary habits could lead to better nutrition therapy in NAFLD patients. The main treatment for chronic hepatitis C (CHC) is interferon-based antiviral therapy, which often causes a decrease in appetite and energy intake; hence, nutritional support is also required during therapy to prevent undernourishment, treatment interruption, and a reduction in quality of life. Moreover, addition of some nutrients that act to suppress viral proliferation is recommended. As a substitutive treatment, low-iron diet therapy, which is relatively safe and effective for preventing hepatocellular carcinoma, is also recommended for CHC patients. Some patients with liver cirrhosis (LC) have decreased dietary energy and protein intake, while the number of LC patients with overeating and obesity is increasing, indicating that the nutritional state of LC patients has a broad spectrum. Therefore, nutrition therapy for LC patients should be planned on an assessment of their complications, nutritional state, and dietary intake. Late evening snacks, branched-chain amino acids, zinc, and probiotics are considered for effective nutritional utilization.

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Clinical trial: oral zinc in hepatic encephalopathy

Abstract: SUMMARY BackgroundHepatic encephalopathy has a negative effect on patient health-related quality of life (HRQOL). Zinc supplementation has been effective with regard to altered nitrogen metabolism.

Cited by 112 publications

References 39 publications

Indications of antibiotic prophylaxis in dental practice–Review

Indications of antibiotic prophylaxis in dental practice–Review

Clinical science workshop: targeting the gut-liver-brain axis

A 12-week Double-blind Randomized Clinical Trial Of Vitamin D3 Supplementation On Body Fat Mass In Healthy Overweight And Obese Women

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