Hepatic encephalopathy: Lessons from preclinical studies

Hepatic encephalopathy (HE) is a major complication that is closely related to the progression of end-stage liver disease. Metabolic changes in advanced liver failure can promote cognition impairment, attention deficits and motor dysfunction that may result in coma and death. HE can be subdivided ac...

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Published inWorld journal of hepatology Vol. 11; no. 2; pp. 173 - 185
Main Authors Lima, Luiza Cioglia Dias, Miranda, Aline Silva, Ferreira, Rodrigo Novaes, Rachid, Milene Alvarenga, Silva, Ana Cristina Simões e
Format Journal Article
LanguageEnglish
Published Baishideng Publishing Group Inc 27.02.2019
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Summary:Hepatic encephalopathy (HE) is a major complication that is closely related to the progression of end-stage liver disease. Metabolic changes in advanced liver failure can promote cognition impairment, attention deficits and motor dysfunction that may result in coma and death. HE can be subdivided according to the type of hepatic injury, namely, type A, which results from acute liver failure, type B, which is associated with a portosystemic shunting without intrinsic liver disease, and type C, which is due to chronic liver disease. Several studies have investigated the pathogenesis of the disease, and most of the mechanisms have been explored using animal models. This article aimed to review the use of preclinical models to investigate HE. The most used animal species are rats and mice. Experimental models of type A HE include surgical procedures and the administration of hepatotoxic medications, whereas models of types B and C HE are generally surgically induced lesions in liver tissue, which evolve to hepatic cirrhosis. Preclinical models have allowed the comprehension of the pathways related to HE.Hepatic encephalopathy (HE) is a major complication that is closely related to the progression of end-stage liver disease. Metabolic changes in advanced liver failure can promote cognition impairment, attention deficits and motor dysfunction that may result in coma and death. HE can be subdivided according to the type of hepatic injury, namely, type A, which results from acute liver failure, type B, which is associated with a portosystemic shunting without intrinsic liver disease, and type C, which is due to chronic liver disease. Several studies have investigated the pathogenesis of the disease, and most of the mechanisms have been explored using animal models. This article aimed to review the use of preclinical models to investigate HE. The most used animal species are rats and mice. Experimental models of type A HE include surgical procedures and the administration of hepatotoxic medications, whereas models of types B and C HE are generally surgically induced lesions in liver tissue, which evolve to hepatic cirrhosis. Preclinical models have allowed the comprehension of the pathways related to HE.
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Author contributions: Lima LCD, Miranda AS, Ferreira RN, Rachid MA and Simões e Silva AC contributed equally to this work, designed and performed the research and analyzed the data.
Corresponding author: Ana Cristina Simoes e Silva, MD, PhD, Full Professor, Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, UFMG, Avenida Alfredo Balena, 190, 2o andar, sala 281, Belo Horizonte, Minas Gerais 30130-100, Brazil.
ISSN:1948-5182
1948-5182
DOI:10.4254/wjh.v11.i2.173