TY - JOUR
T1 - Characterization of Oxidative Stress and Ammonia According to the Different Grades of Hepatic Encephalopathy
AU - Montes-Cortes, Daniel Hector
AU - Olivares-Corichi, Ivonne M.
AU - Rosas-Barrientos, José Vicente
AU - Manuel-Apolinar, Leticia
AU - Martìnez-Godinez, María De Los Angeles
AU - Hernández-López, Juan Carlos
AU - Cruz-Dominguez, Maria Del Pilar
N1 - Publisher Copyright:
© 2019 S. Karger AG, Basel. Copyright: All rights reserved.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Background: Hepatic encephalopathy (HE) in patients with chronic liver disease (CLD) is one of the main causes of reentry to the emergency department. Oxidative stress (OxS) regulated by ammonia leads to cerebral edema and astrocytes senescence in animal models, but seems to be different in humans. Objective: To analyze if OxS and ammonia in plasma are related to each other in the different grades of HE-CLD and to compare them with healthy volunteers (HV). Methods: In a cross-sectional study, we included 60 subjects in 2 groups: (a) 30 HV and (b) 30 HE patients. Plasma levels of oxidation lipids/proteins, ammonia, and West-Haven score were evaluated. Student t test, Spearman's correlation, and ANOVA with Dunn's post hoc test were performed. Results: Ammonia in HV and HE patients was 39-49 vs. 95-345 μmol/L, respectively (p < 0.0001). Malondialdehyde (MDA) in HV was 6.58 ± 3.11 compared to 16.69 ± 6.19 μmol/L in HE (p < 0.0001). Protein oxidation by osazone (carbonyls), formazan, and dityrosines was higher in HE than in HV (p < 0.0001). Ammonia level was directly associated to HE severity, but without correlation with lipid MDA or protein OxS formazan, carbonyls, and dityrosines. Lipid peroxidation showed higher levels at degree 2 and protein oxidation at degree 3 of HE. Conclusions: We confirm that OxS accompanies hyperammonemia in HE; however they contribute in different proportions to their natural progression. Early reduction of OxS in HE could contribute to minimize the neurotoxicity into CLD.
AB - Background: Hepatic encephalopathy (HE) in patients with chronic liver disease (CLD) is one of the main causes of reentry to the emergency department. Oxidative stress (OxS) regulated by ammonia leads to cerebral edema and astrocytes senescence in animal models, but seems to be different in humans. Objective: To analyze if OxS and ammonia in plasma are related to each other in the different grades of HE-CLD and to compare them with healthy volunteers (HV). Methods: In a cross-sectional study, we included 60 subjects in 2 groups: (a) 30 HV and (b) 30 HE patients. Plasma levels of oxidation lipids/proteins, ammonia, and West-Haven score were evaluated. Student t test, Spearman's correlation, and ANOVA with Dunn's post hoc test were performed. Results: Ammonia in HV and HE patients was 39-49 vs. 95-345 μmol/L, respectively (p < 0.0001). Malondialdehyde (MDA) in HV was 6.58 ± 3.11 compared to 16.69 ± 6.19 μmol/L in HE (p < 0.0001). Protein oxidation by osazone (carbonyls), formazan, and dityrosines was higher in HE than in HV (p < 0.0001). Ammonia level was directly associated to HE severity, but without correlation with lipid MDA or protein OxS formazan, carbonyls, and dityrosines. Lipid peroxidation showed higher levels at degree 2 and protein oxidation at degree 3 of HE. Conclusions: We confirm that OxS accompanies hyperammonemia in HE; however they contribute in different proportions to their natural progression. Early reduction of OxS in HE could contribute to minimize the neurotoxicity into CLD.
KW - Ammonia
KW - Chronic liver disease
KW - Hepatic encephalopathy
KW - Lipid peroxidation
KW - Protein oxidation
UR - http://www.scopus.com/inward/record.url?scp=85073188641&partnerID=8YFLogxK
U2 - 10.1159/000503097
DO - 10.1159/000503097
M3 - Artículo
C2 - 31578013
AN - SCOPUS:85073188641
SN - 0257-2753
VL - 38
SP - 240
EP - 250
JO - Digestive Diseases
JF - Digestive Diseases
IS - 3
ER -