Abstract | BACKGROUND: AIMS: PATIENTS AND METHODS: Sixty patients of cirrhosis with MHE were randomized to two groups, Gr. MHE-L (n = 30), treated with lactulose for 3 months, and Gr. MHE-NL (n = 30), who did not received lactulose. Arterial ammonia, TNF-α, IL-6, IL-18, serum endotoxin, and MRS were performed in all patients at baseline and at 3 months and 20 patients of cirrhosis without MHE and 20 healthy controls. RESULTS: After 3 months, median arterial ammonia (69.4 vs 52.7 mcg/dL), TNF-α (26.6 vs 22 pg/mL), IL-6 (17.6 vs 12.4 pg/mL), IL-18 (42.5 vs 29 pg/mL), and serum endotoxin (0.68 vs 0.43 EU/mL) significantly decreased in Gr. MHE-L compared with baseline (P < 0.0001), while no change was seen in Gr. MHE-NL patients. On MRS, compared with patients of cirrhosis without MHE, mI and cho were significantly lower (P < 0.001) and glutamine (Glx) was significantly higher in both MHE groups (P < 0.001). After 3 months, mI and cho increased and Glx decreased significantly in Gr. MHE-L (P < 0.001), without changes in Gr. MHE-NL patients. Psychometric hepatic encephalopathic score (PHES) correlated well with arterial ammonia, TNF-α, IL-6, IL-18, serum endotoxin, and metabolic parameters on MRS. CONCLUSIONS:
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Authors | Lokesh Jain, Barjesh Chander Sharma, Siddharth Srivastava, Sunil Kumar Puri, Praveen Sharma, Shiv Sarin |
Journal | Journal of gastroenterology and hepatology
(J Gastroenterol Hepatol)
Vol. 28
Issue 7
Pg. 1187-93
(Jul 2013)
ISSN: 1440-1746 [Electronic] Australia |
PMID | 23425082
(Publication Type: Journal Article, Randomized Controlled Trial)
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Copyright | © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd. |
Chemical References |
- Biomarkers
- Endotoxins
- Gastrointestinal Agents
- Inflammation Mediators
- Interleukin-18
- Interleukin-6
- Tumor Necrosis Factor-alpha
- Lactulose
- Ammonia
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Topics |
- Adolescent
- Adult
- Aged
- Ammonia
(blood)
- Biomarkers
(blood)
- Endotoxins
(blood)
- Female
- Gastrointestinal Agents
(therapeutic use)
- Hepatic Encephalopathy
(diagnosis, drug therapy, etiology)
- Humans
- Inflammation Mediators
(blood)
- Interleukin-18
(blood)
- Interleukin-6
(blood)
- Lactulose
(therapeutic use)
- Liver Cirrhosis
(complications)
- Magnetic Resonance Spectroscopy
- Male
- Middle Aged
- Tumor Necrosis Factor-alpha
(blood)
- Young Adult
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