ascorbic-acid and Hepatic-Encephalopathy

The sequence of events in hepatic encephalopathy (HE) remains unclear. Using the advantages of in vivo 1H-MRS (9.4T) we aimed to analyse the time-course of disease in an established model of type C HE by analysing the longitudinal changes in a large number of brain metabolites together with biochemical, histological and behavioural assessment. We hypothesized that neurometabolic changes are detectable very early, and that these early changes will offer insight into the primary events underpinning HE.. Wistar rats underwent bile-duct ligation (BDL) and were studied before BDL and at post-operative weeks 2, 4, 6 and 8 (n = 26). In vivo short echo-time. Plasma ammonium increased early after BDL and remained high during the study. Brain glutamine increased (+47%) as early as 2-4 weeks post-BDL while creatine (-8%) and ascorbate (-12%) decreased. Brain glutamine and ascorbate correlated closely with rising plasma ammonium, while brain creatine correlated with brain glutamine. The increases in brain glutamine and plasma ammonium were correlated, while plasma ammonium correlated negatively with distance moved. Changes in astrocyte morphology were observed at 4 weeks. These early changes were further accentuated at 6-8 weeks post-BDL, concurrently with the known decreases in brain organic osmolytes.. Using a multimodal, in vivo and longitudinal approach we have shown that neurometabolic changes are already noticeable 2 weeks after BDL. These early changes are suggestive of osmotic/oxidative stress and are likely the premise of some later changes. Early decreases in cerebral creatine and ascorbate are novel findings offering new avenues to explore neuroprotective strategies for HE treatment.. The sequence of events in chronic hepatic encephalopathy (HE) remains unclear, therefore using the advantages of in vivo proton magnetic resonance spectroscopy at 9.4T we aimed to test the hypothesis that neurometabolic changes are detectable very early in an established model of type C HE, offering insight into the primary events underpinning HE, before advanced liver disease confounds the findings. These early, previously unreported neurometabolic changes occurred as early as 2 to 4 weeks after bile-duct ligation, namely an increase in plasma ammonium and brain glutamine, a decrease in brain creatine and ascorbate together with behavioural and astrocyte morphology changes, and continued to progress throughout the 8-week course of the disease.

Topics: Ammonium Compounds; Animals; Ascorbic Acid; Astrocytes; Chronic Disease; Creatine; Disease Models, Animal; Glutamine; Hepatic Encephalopathy; Hippocampus; Male; Oxidative Stress; Proton Magnetic Resonance Spectroscopy; Rats; Rats, Wistar

Thioacetamide (TAA) has been used in development of animal models of acute hepatic encephalopathy (AHE). This experimental study was designed to evaluate effects of oral administration of vitamin C, vitamin E and their combination on liver and brain enzymes and their histologic and ultrastructure changes. Eighty Wistar rats were included and divided into five groups (16 each). Group 1 (control) received saline once intraperitoneally (IP) then administered orally saline and corn oil for 3 days. Group 2 [hepatotoxic (TAA)] were received TAA (300mg/kg) once intraperitoneally (IP). Group 3 (vitamin C and TAA) received TAA (300mg/kg) once intraperitoneally (IP) and then administered orally vitamin C (100mg/kg) daily for 3 days. Group 4 (vitamin E and TAA) received TAA (300mg/kg) once intraperitoneally (IP) and then administered orally vitamin E (200mg/kg) daily for 3 days. Group 5 (vitamin C and vitamin E and TAA) received TAA (300mg/kg) once intraperitoneally (IP) and then administered orally vitamin C (100mg/kg) in combination with vitamin E (200mg/kg) daily for 3 days. All rats were sacrificed 24h after last treatment under anesthesia. Blood samples were collected and serum was obtained for analysis of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), total protein, triglyceride, cholesterol using spectrophotometer and ELISA kits. Liver and brain were extracted and tissue homogenate was used to measure malondialdehyde (MDA), reduced glutathione (GSH) and nitric oxide (NO). Histological and ultrastructure examination were done. TAA induced significant increase of MDA and decreased in GSH and NO in both liver and brain homogenate with more liver affection, and increased in serum levels of AST, ALT, triglyceride, cholesterol and decreased in total protein. Furthermore, there is decrease in serum levels of AST, ALT, triglyceride, cholesterol and tissue levels of MDA and elevated serum total protein and tissue GSH and NO under the umbrella of vitamin C and vitamin E and their combination, although vitamin E is more efficient. These data showed protective effect of vitamins C and E, especially vitamin E against oxidative stress and hepatic and brain damage, and histological architecture of the liver in rats' model of acute hepatic encephalopathy elicited by TAA.

Topics: Alanine Transaminase; Animals; Antioxidants; Ascorbic Acid; Aspartate Aminotransferases; Brain; Glutathione; Hepatic Encephalopathy; Liver; Male; Malondialdehyde; Nitric Oxide; Oxidative Stress; Rats; Rats, Wistar; Thioacetamide; Vitamin E

Topics: Acute Disease; Adult; Aminophylline; Ascorbic Acid; Blood Transfusion; Drug Therapy, Combination; Hepatic Encephalopathy; Humans; Male; Mushroom Poisoning; Prednisolone; Thiamine Pyrophosphate

Topics: Acute Disease; Ascites; Ascorbic Acid; Blood Protein Disorders; Diet Therapy; Diuretics; Glucocorticoids; Hemorrhagic Disorders; Hepatic Encephalopathy; Hepatitis A; Humans; Mineralocorticoid Receptor Antagonists; Rest; Rutin; Serum Albumin; Vitamin K

Topics: Adolescent; Ascorbic Acid; Cortisone; gamma-Globulins; Hepatic Encephalopathy; Hepatitis; Hepatitis A; Humans; Infusions, Parenteral; Niacin; Niacinamide; Pyridoxine; Riboflavin; Vitamin B 12; Vitamin E