Journal
CLINICS IN LIVER DISEASE
Volume 16, Issue 1, Pages 7-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.cld.2011.12.010
Keywords
Hepatic encephalopathy; Ammonia; GABA; GABA(A) receptor complex
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The earliest hypothesis of the pathogenesis of HE implicated ammonia, although effects of appreciable concentrations of this neurotoxin did not resemble HE. Altered eurotransmission in the brain was suggested by similarities between increased GABA-mediated inhibitory neurotransmission and HE, specifically decreased consciousness and impaired motor function. Evidence of increased GABAergic tone in models of HE has accumulated; potential mechanisms include increased synaptic availability of GABA and accumulation of natural benzodiazepine receptor ligands with agonist properties. Pathophysiological concentrations of ammonia associated with HE, have the potential of enhancing GABAergic tone by mechanisms that involve its interactions with the GABA(A) receptor complex.
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