Novel Therapies in Hepatic Encephalopathy

Alimirah, Maryam; Sadiq, Omar; Gordon, Stuart C.

doi:10.1016/j.cld.2020.01.009

Cited by 12 publications

(5 citation statements)

References 78 publications

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“…The metabolism of amino acids by the gut microbiota is an important pathway for the source of ammonia in the gut. [ 42 ] At level 3, there was an increase in LPS biosynthesis in the HE group, thus confirming the dysregulation of gut microbiota. After EGCG intervention, the increase in the category was reduced to levels tending to the NC group.…”

Section: Discussionmentioning

confidence: 79%

Green Tea Catechin EGCG Ameliorates Thioacetamide‐Induced Hepatic Encephalopathy in Rats via Modulation of the Microbiota‐Gut‐Liver Axis

Zhou

Guo

et al. 2023

Molecular Nutrition Food Res

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Scope: Existing research suggests that (−)-epigallocatechin-3-gallate (EGCG), which is a natural tea catechin active substance, can protect against liver injury. However, its mechanism for hepatic encephalopathy (HE) treatment is still unclear. In this study, the role of EGCG in the amelioration of HE rats and the effect on the microbiota-gut-liver axis are mainly analyzed. Methods and results: Thioacetamide (TAA) is employed to induce the HE model in rats. The results of open field test show that EGCG restores locomotor activity and exploratory behavior. Histological and biochemical results demonstrate that EGCG ameliorates brain and liver damage, decreases the expression of pro-inflammatory cytokines, and increases the activity of antioxidant enzymes. Meanwhile, EGCG modulates the Nrf2 pathway and TLR4/NF-𝜿B pathway to mitigate TAA-induced oxidative stress and inflammatory responses. Immunohistochemistry reveals protection of the intestinal barrier by EGCG upregulating the expression of occludin and zonula occludens-1. Furthermore, serum levels of ammonia and LPS are reduced. 16S rRNA analysis shows that EGCG treatment increases the abundance of beneficial bacteria (e.g., Bifidobacterium, Lactobacillus, and Limosilactobacillus). Conclusion: The above results reveal that EGCG has anti-oxidative stress and anti-inflammatory effects, and ameliorates the condition through the microbiota-gut-liver axis, with potential for the treatment of HE.

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Section: Discussionmentioning

confidence: 79%

Green Tea Catechin EGCG Ameliorates Thioacetamide‐Induced Hepatic Encephalopathy in Rats via Modulation of the Microbiota‐Gut‐Liver Axis

Zhou

Guo

et al. 2023

Molecular Nutrition Food Res

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“…Probiotics: probiotics are live micro-organisms that are capable of modulating the host gut microbiome, decreasing the burden of pathogenic intestinal bacteria and ameliorating the toxic effects of bacterial translocation in cirrhosis [96]. There is a lack of strong evidence supporting the use of probiotics in patients with HE.…”

Section: Overview Of Available Pharmacological Treatments For Hementioning

confidence: 99%

Old and New Precipitants in Hepatic Encephalopathy: A New Look at a Field in Continuous Evolution

Bellafante

Gioia

Faccioli

et al. 2023

JCM

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Hepatic encephalopathy (HE) is a common complication in patients with advanced liver disease. It is a brain dysfunction characterized by neurological and psychiatric symptoms that significantly affects quality of life, morbidity and mortality of patients. HE has various precipitants that can potentially promote its onset, alone or in combination. Among the historically well-known precipitants, such as infections, gastrointestinal bleeding, dehydration, electrolyte disorders and constipation, recent studies have highlighted the role of malnutrition and portosystemic shunts as new precipitating factors of HE. The identification, management and correction of these factors are fundamental for effective HE treatment, in addition to pharmacological therapy with non-absorbable disaccharides and/or antibiotics.

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“…Rifaximin is a rifamycin-based nonsystemic antibiotic with low gastrointestinal absorption and good antibacterial activity[ 89 , 99 ]. The gastrointestinal tract is the main therapeutic target of rifaximin, and it has been widely used in controlling HE with infrequent side effects and a favorable long-term safety profile[ 100 , 101 ].…”

Section: Gut Microbiota-related Treatment Toward Hbv-related Fibrosis...mentioning

confidence: 99%

Gut microbiota alteration and modulation in hepatitis B virus-related fibrosis and complications: Molecular mechanisms and therapeutic inventions

Li¹,

Yu²,

Li³

et al. 2022

WJG

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Hepatitis B virus (HBV) has posed a threat to public health, mainly resulting in liver damage. With long-term accumulation of extracellular matrix, patients with chronic hepatitis B are at high risk of developing into liver fibrosis and cirrhosis and even life-threatening hepatic carcinoma. The occurrence of complications such as spontaneous bacterial peritonitis and hepatic encephalopathy greatly increases disability and mortality. With deeper understanding of the bidirectional interaction between the liver and the gut (gut-liver axis), there is a growing consensus that the human health closely relates to the gut microbiota. Supported by animal and human studies, the gut microbiota alters as the HBV-related liver fibrosis initials and progresses, characterized as the decrease of the ratio between “good” and “potentially pathogenic” microbes. When the primary disease is controlled via antiviral treatment, the gut microbiota dysfunction tends to be improved. Conversely, the recovery of gut microbiota can promote the regression of liver fibrosis. Therapeutic strategies targeted on gut microbiota (rifaximin, probiotics, engineered probiotics and fecal microbiota transplantation) have been applied to animal models and patients, obtaining satisfactory results.

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Novel Therapies in Hepatic Encephalopathy

Cited by 12 publications

References 78 publications

Green Tea Catechin EGCG Ameliorates Thioacetamide‐Induced Hepatic Encephalopathy in Rats via Modulation of the Microbiota‐Gut‐Liver Axis

Green Tea Catechin EGCG Ameliorates Thioacetamide‐Induced Hepatic Encephalopathy in Rats via Modulation of the Microbiota‐Gut‐Liver Axis

Old and New Precipitants in Hepatic Encephalopathy: A New Look at a Field in Continuous Evolution

Gut microbiota alteration and modulation in hepatitis B virus-related fibrosis and complications: Molecular mechanisms and therapeutic inventions

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