Open AccessNew approaches to the pathogenesis, clinic, and treatment of hepatic encephalopathy
Author(s) -
С Д Подымова
Publication year - 2021
Publication title -
terapevtičeskij arhiv
Language(s) - English
Resource type - Journals
eISSN - 2309-5342
pISSN - 0040-3660
DOI - 10.26442/00403660.2021.02.200613
Subject(s) - medicine , hepatic encephalopathy , pathogenesis , cirrhosis , hyperammonemia , encephalopathy , glutamine , antagonist , bioinformatics , pharmacology , receptor , amino acid , biochemistry , biology , chemistry
This review article presents new approaches to the assessment of key pathogenesis factors, clinical features, and treatment of hepatic encephalopathy (HE) associated with liver cirrhosis. Various clinical variants of the course of HE in patients with cirrhosis of the liver areconsidered, which are important for the choice of treatment and prevention of repeated relapses of HE. Analyzed the ammonia hypothesis of pathogenesis and associated hyperammonemia, which is the basis of most modern treatment methods. These data on the activation of the adaptive pathway for removing ammonia in the form of glutamine are used in the further study of drugs that enhance the clearance of ammonia. The possibility of reducing GABA-ergic tone due to the effect of the antagonist on the neurosteroid site in the GABA receptor complex is emphasized.