HYPERAMMONEMIA, PLASMA AMINO-ACID IMBALANCE, AND BLOOD-BRAIN AMINO-ACID-TRANSPORT - UNIFIED THEORY OF PORTAL-SYSTEMIC ENCEPHALOPATHY

被引：393

作者：

JAMES, JH ^{[1
]}

JEPPSSON, B ^{[1
]}

ZIPARO, V ^{[1
]}

FISCHER, JE ^{[1
]}

机构：

[1] UNIV CINCINNATI,CINCINNATI GEN HOSP,MED CTR,DEPT SURG,CINCINNATI,OH 45267

来源：

LANCET | 1979年 / 2卷 / 8146期

关键词：

D O I：

10.1016/S0140-6736(79)92119-6

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

It is proposed that hyperammonæmia in liver cirrhosis or after portacaval shunt contributes to plasma neutral aminoacid imbalance and to increased activity of the blood-brain neutral aminoacid transport system. Plasma neutral aminoacid concentrations are deranged, partly, but not completely, because ammonia stimulates glucagon secretion; a high rate of gluconeogenesis and hyperinsulinæmia follow. Brain uptake of neutral aminoacids rises because ammonia stimulates brain-glutamine synthesis, which results in rapid exchange of brain glutamine for plasma neutral aminoacids. Hyperammonæmia therefore contributes to encephalopathy indirectly, by raising the brain concentration of neutral aminoacids which alter neurotransmitter metabolism, rather than directly, by toxic effects on neuronal metabolism. © 1979.

引用

页码：772 / 775

页数：4

共 29 条

[1] SEROTONIN METABOLISM IN RAT-BRAIN AFTER SURGICAL DIVERSION OF PORTAL VENOUS CIRCULATION [J].

BALDESSARINI, RJ ;

FISCHER, JE .

NATURE-NEW BIOLOGY, 1973, 245 (140) :25-27

[2] REGIONAL BRAIN INDOLEAMINE METABOLISM FOLLOWING CHRONIC PORTACAVAL ANASTOMOSIS IN RAT [J].

CUMMINGS, MG ;

SOETERS, PB ;

JAMES, JH ;

KEANE, JM ;

FISCHER, JE .

JOURNAL OF NEUROCHEMISTRY, 1976, 27 (02) :501-509

[3] EFFECTS OF CHRONIC PORTACAVAL ANASTOMOSIS ON BRAIN TRYPTOPHAN, TYROSINE AND 5-HYDROXYTRYPTAMINE [J].

CURZON, G ;

KANTAMANENI, BD ;

FERNANDO, JC ;

WOODS, MS ;

CAVANAGH, JB .

JOURNAL OF NEUROCHEMISTRY, 1975, 24 (05) :1065-1070

[4] NEUTRAL AMINO-ACIDS IN BRAIN - CHANGES IN RESPONSE TO FOOD INGESTION [J].

FERNSTROM, JD ;

FALLER, DV .

JOURNAL OF NEUROCHEMISTRY, 1978, 30 (06) :1531-1538

[5] ELEVATION OF PLASMA TRYPTOPHAN BY INSULIN IN RAT [J].

FERNSTROM, JD ;

WURTMAN, RJ .

METABOLISM-CLINICAL AND EXPERIMENTAL, 1972, 21 (04) :337-+

[6]

FISCHER JE, 1975, SURGERY, V78, P276

[7]

FISCHER JE, 1976, SURGERY, V80, P77

[8] CEREBRAL BLOOD-FLOW AND METABOLISM IN CHRONICALLY HYPERAMMONEMIC RATS - EFFECT OF AN ACUTE AMMONIA CHALLENGE [J].

GJEDDE, A ;

LOCKWOOD, AH ;

DUFFY, TE ;

PLUM, F .

ANNALS OF NEUROLOGY, 1978, 3 (04) :325-330

[9] ACUTE ACTION OF AMMONIA ON RAT-BRAIN METABOLISM IN-VIVO [J].

HAWKINS, RA ;

MILLER, AL ;

NIELSEN, RC ;

VEECH, RL .

BIOCHEMICAL JOURNAL, 1973, 134 (04) :1001-1008

[10] ISOLATED MICROVESSELS - BLOOD-BRAIN-BARRIER INVITRO [J].

HJELLE, JT ;

BAIRDLAMBERT, J ;

CARDINALE, G ;

SPECTOR, S ;

UDENFRIEND, S .

PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 1978, 75 (09) :4544-4548

← 1 2 3 →