Altered response to oral glutamine challenge as prognostic factor for overt episodes in patients with minimal hepatic encephalopathy

Journal of Hepatology

Volumn 37, Issue 6, 2002, Pages 781-787

  Romero Gómez, Manuel ^a   Grande, Lourdes ^a   Camacho, Inés ^a   Benitez, Soledad ^a   Irles, José A ^a   Castro, Manuel ^a  

^a HOSPITAL UNIVERSITARIO DE VALME   (Spain)

Author keywords

Amino acids; Ammonia; Ammonia partial pressure; Helicobacter pylori; Psychometric test

Indexed keywords

AMMONIA; GLUTAMINE;

ADULT; AMMONIA BLOOD LEVEL; ARTICLE; CONCENTRATION RESPONSE; CONTROLLED STUDY; DIAGNOSTIC VALUE; FEMALE; FOLLOW UP; FUNCTION TEST; HELICOBACTER PYLORI; HEPATIC ENCEPHALOPATHY; HUMAN; LIVER CIRRHOSIS; MAJOR CLINICAL STUDY; MALE; MULTIPLE REGRESSION; ORAL GLUTAMINE CHALLENGE; PRIORITY JOURNAL; PROGNOSIS; PSYCHOMETRY; RISK ASSESSMENT; BLOOD; HELICOBACTER INFECTION; HOSPITALIZATION; LIVER; MIDDLE AGED; MULTIVARIATE ANALYSIS; ORAL DRUG ADMINISTRATION; OSMOLARITY; PATHOPHYSIOLOGY; PRESSURE; RISK FACTOR;

ADMINISTRATION, ORAL; AMMONIA; GLUTAMINE; HELICOBACTER INFECTIONS; HELICOBACTER PYLORI; HEPATIC ENCEPHALOPATHY; HUMANS; LIVER; MIDDLE AGED; MULTIVARIATE ANALYSIS; OSMOLAR CONCENTRATION; PARTIAL PRESSURE; PROGNOSIS; RISK FACTORS; SEVERITY OF ILLNESS INDEX;

EID: 0036892326     PISSN: 01688278     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0168-8278(02)00330-6     Document Type: Article

References (31)

1. Rikkers L, Jenko P, Rudman D, Freides D. Subclinical hepatic encephalopathy: Detection, prevalence, and relationship to nitrogen metabolism. Gastroenterology 1978;75:462-469.
2. Quero JC, Hartmann JC, Meulstee J, Hop WIC, Schalm SW. The diagnosis of subclinical hepatic encephalopathy in patients with cirrhosis using neuropsychological test and automated electroencephalogram analysis. Hepatology 1996;24:556-560.
3. Perez-Cuadrado E, Silva-Gonzalez C, Robles-Reyes A. Variabilidad y alargamiento del tiempo de reacción en el diagnóstico precoz de la encefalopatía hepatica subclínica. Rev Esp Enf Digest 1990;77(1):29-32.
4. Marchesini G, Zoli M, Dondi C, Cecchini L, Angiolini A, Bianchi FB, et al. Prevalence of subclinical hepatic encephalopathy in cirrhotics and relationship to plasma amino acid imbalance. Dig Dis Sci 1980;25:763-768.
5. Kramer L, Tribl B, Gendo A, Zauner C, Schneider B, Ferenci P, et al. Partial pressure of ammonia versus ammonia in hepatic encephalopathy. Hepatology 2000;31:30-34.
6. Vince A, Dawson AM, Park N. Ammonia production by intestinal bacteria. Gut 1973;14:171-177.
7. James LA, Lunn PG, Middleton S, Elia M. Distribution of glutaminase and glutamine synthetase activities in the human gastrointestinal tract. Clin Sci 1998;94:313-319.
8. Oppong KN, Al-Mardini H, Thick M, Record CO. Oral glutamine challenge in cirrhotics pre- and post-liver transplantation: A psychometric and analysed EEG study. Hepatology 1997;26:870-876.
9. Dechelotte P, Darmaun D, Rongier M, Heckestsweiler B, Rigal O, Desjeux J. Absorption and metabolic effects of enterally administered glutamine in humans. Am J Physiol 1991;260:G677-G682.
10. Souba VW, Smith RJ, Wilmore DW. Glutamine metabolism by the intestinal tract. J Parem Enteral Nutr 1985;9:608-617.
11. Romero Gomez M, Boza F, Garcia Valdecasas MS, García E, Aguilar Reina J. Sub-clinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy. Am J Gastroenterol 2001;96:2718-2723.
12. Amodio P, Del Piccolo F, Marchetti P, Angeli P, Iemmolo R, Caregaro L, et al. Clinical features and survival of cirrhotic patients with subclinical cognitive alterations detected by the number connection test and computerised psychometric test. Hepatology 1999;29:1662-1667.
13. Manning RT. A nomogram for estimation of pNH3. J Lab Clin Med 1964;63:297-298.
14. Weber FL, Veach G. The importance of the small intestine in gut ammonium production in the fasting dogs. Gastroenterology 1979;3:235-240.
15. Das A, Dhiman RK, Saraswat VA, Verma M, Naik SR. Prevalence and natural history of subclinical hepatic encephalopathy in cirrhosis. J Gastroenterol Hepatol 2001;16:531-535.
16. Hartmann IJC, Groeneweg M, Quero JC, Beijeman SJ, Man RA, Hop WCJ, et al. The prognostic significance of sub-clinical hepatic encephalopathy. Am J Gastroenterol 2000;95:2029-2034.
17. Plauth M, Roske AE, Romananiuk P, Roth E, Ziebig R, Lochs H. Post-feeding hyperammonaemia in patients with transjugular intrahepatic portosystemic shunts and liver cirrhosis: Role of small intestinal ammonia release and route of nutrient administration. Gut 2000;46:849-855.
18. Stahl J. Studies of the blood ammonia in liver disease. Its diagnostic, prognostic, and therapeutic significance. Ann Int Med 1963;58:1-24.
19. Bianchi G, Marchesini G, Vilstrup H, Fabbri A, De Mitri MS, Zoli M, et al. Hepatic amino nitrogen clearance to urea-nitrogen in control subjects, and in patients with cirrhosis. A simplified method. Hepatology 1991;13:460-466.
20. Efrati C, Masini A, Merli M, Valeriano V, Riggio O. Effect of sodium benzoate on blood ammonia response to oral glutamine challenge in cirrhotic patients: A note of caution. Am J Gastroenterol 2000;95:3574-3578.
21. Masini A, Efrati C, Merli M, Attili AF, Amodio P, Ceccanti M. et al. Effect of lactitol on blood ammonia response to oral glutamine challenge in cirrhotic patients: Evidence for an effect of non-absorbable disaccharidases on small intestine ammonia generation. Am J Gastroenterol 1999;94:3323-3327.
22. Hawkins RA, Jessy J, Mans AM, Chedid A, DeJoseph MR. Neomycin reduces the intestinal production of ammonia from glutamine. In: Felipo V, Grisolía S, editors. Hepatic encephalopathy, hyperammonemia and ammonia toxicity, New York: Plenum, 1994. pp. 125-134.
23. Rees CJ, Oppong K, Al Mardini H, Hudson M, Record CO. Effect of L-ornithine L-aspartate on patients with and without TIPS undergoing glutamine challenge: A double blind, placebo controlled trial. Gut 2000;47:571-574.
24. Gitlin N, Lewis DC, Hinkley L. The diagnosis and prevalence of subclinical hepatic encephalopathy in apparently healthy, ambulant, non-shunted patients with cirrhosis. J Hepatol 1986;3:75-82.
25. Gilberstadt SJ, Gilberstadt H, Zieve L, Beugel B, Collier RO, McClain CJ. Psychomotor performance defects in cirrhotic patients without overt encephalopathy. Arch Intern Med 1980;140:519-521.
26. Groeneweg M, Quero JC, De Brujin I, Hartmann IJ, Essink-bot ML, Hop WCJ, et al. Sub-clinical hepatic encephalopathy impairs daily functioning. Hepatology 1998;28:45-49.
27. Mendz GL, Hazell SL. Amino acid utilisation by Helicobacter pylori. Int J Biochem Cell Biol 1995;27:1085-1093.
28. Stark RM, Suleiman MS, Hassan IJ, Greenman J, Millar MR. Amino acid utilisation and deamination of glutamine and asparagine by H. pylori. J Med Microbiol 1997;46:793-800.
29. Zullo A, Rinaldi V, Meddi P, Hassan C, Winn S, Attili AF. Helicobacter pylori infection, plasma ammonia levels, and psychometric testing in cirrhotic patients. Am J Gastroenterol 1999;94:2214-2218.
30. Vasconez C, Elizalde JI, Llach J, Gines A, de la Rosa C, Fernández RM, et al. Helicobacter pylori, hyperammonemia and sub-clinical portosystemic encephalopathy: Effects of eradication. J Hepatol 1999;30:260-264.
31. Suto H. Azuma T, Ito S, Ohtami M, Dojo M, Ito Y, et al. Helicobacter pylori infection induces hyperammonaemia in mongolian gerbils with liver cirrosis. Gut 2001;48:605-4508.