Interorgan ammonia metabolism in liver failure: the basis of current and future therapies.

G. Wright, L. Noiret, S. Olde Damink, R.A. Jalan

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39 Citations (Scopus)

Abstract

Abstract Hepatic encephalopathy complicates the course of both acute and chronic liver disease and its treatment remains an unmet clinical need. Ammonia is thought to be central in its pathogenesis and remains an important target of current and future therapeutic approaches. In liver failure, the main detoxification pathway of ammonia metabolism is compromised leading to hyperammonaemia. In this situation, the other ammonia-regulating pathways in multiple organs assume important significance. The present review focuses upon interorgan ammonia metabolism in health and disease describing the role of the key enzymes, glutamine synthase and glutaminase. Better understanding of these alternative pathways are leading to the development of new therapeutic approaches.
Original languageEnglish
Pages (from-to)163-175
Number of pages13
JournalLiver International
Volume31
Issue number2
DOIs
Publication statusPublished - Feb 2011

Keywords

  • amino acid metabolism
  • ammonia
  • hepatic encephalopathy
  • interorgan
  • liver failure
  • FULMINANT HEPATIC-FAILURE
  • INTERCELLULAR GLUTAMINE CYCLE
  • AMINO-ACID-METABOLISM
  • RED-BLOOD-CELLS
  • L-ORNITHINE
  • INBORN-ERRORS
  • RAT-LIVER
  • NITROGEN-METABOLISM
  • CIRRHOTIC SUBJECTS
  • SMALL-INTESTINE

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