Astrocyte swelling in hepatic encephalopathy: molecular perspective of cytotoxic edema.

Metabolic Brain Disease
Ali SepehrinezhadRoger Williams

Abstract

Hepatic encephalopathy (HE) may occur in patients with liver failure. The most critical pathophysiologic mechanism of HE is cerebral edema following systemic hyperammonemia. The dysfunctional liver cannot eliminate circulatory ammonia, so its plasma and brain levels rise sharply. Astrocytes, the only cells that are responsible for ammonia detoxification in the brain, are dynamic cells with unique phenotypic properties that enable them to respond to small changes in their environment. Any pathological changes in astrocytes may cause neurological disturbances such as HE. Astrocyte swelling is the leading cause of cerebral edema, which may cause brain herniation and death by increasing intracranial pressure. Various factors may have a role in astrocyte swelling. However, the exact molecular mechanism of astrocyte swelling is not fully understood. This article discusses the possible mechanisms of astrocyte swelling which related to hyperammonia, including the possible roles of molecules like glutamine, lactate, aquaporin-4 water channel, 18 KDa translocator protein, glial fibrillary acidic protein, alanine, glutathione, toll-like receptor 4, epidermal growth factor receptor, glutamate, and manganese, as well as inflammation, oxidat...Continue Reading

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Citations

Aug 8, 2020·Psychopharmacology·Somayeh BaghbaderaniMaliheh Entezari
Jan 16, 2021·Journal of Clinical Medicine·Laura I ComanMihai Ciocîrlan
Jan 21, 2021·International Journal of Molecular Sciences·So Yeong Cheon, Juhyun Song
Apr 13, 2021·Scandinavian Journal of Gastroenterology·Mathias MadsenAndreas Munk Petersen

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Methods Mentioned

BETA
protein folding
PCA
dissect

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