Peripheral and splanchnic indole and oxindole levels in cirrhotic patients: a study on the pathophysiology of hepatic encephalopathy

The American Journal of Gastroenterology
Oliviero RiggioF Moroni

Abstract

Intestinal bacteria metabolize tryptophan into indole, which is then further metabolized into oxindole, a sedative compound putatively involved in the pathophysiology of hepatic encephalopathy (HE). The aim of this study was to measure indole and oxindole levels in patients with cirrhosis with or without HE and to establish whether an intestinal production and a hepatic metabolism of these substances exist. We studied 10 healthy subjects (controls) and 51 cirrhotic patients: 17 without HE, 14 with a minimal HE, 8 with overt HE, and 12 who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure. In the last group, blood was collected from the artery, and the portal and hepatic veins during TIPS construction and from the peripheral veins before, immediately after, and at weekly intervals during the first month after TIPS. Plasma indole levels were significantly higher in patients with overt HE. Oxindole levels were higher in cirrhotics than in controls. Indole and ammonia were significantly correlated (r=0.66). Peripheral and splanchnic determinations showed that indole was produced in the intestine and cleared by the liver, similar to ammonia. TIPS implantation increased both indole and ammonia levels. Aft...Continue Reading

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Citations

Jul 24, 2012·American Journal of Physiology. Gastrointestinal and Liver Physiology·Jasmohan S BajajPatrick M Gillevet
Sep 26, 2012·Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association·Wissam Bleibel, Abdullah M S Al-Osaimi
Sep 12, 2012·World Journal of Gastrointestinal Pharmacology and Therapeutics·Angelo ZulloOliviero Riggio
Oct 2, 2012·International Journal of Hepatology·Said A Al-BusafiNir Hilzenrat
Feb 8, 2013·Metabolic Brain Disease·Kavish R Patidar, Jasmohan S Bajaj
Feb 28, 2018·Food & Function·Andrea ManciniKieran M Tuohy
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Sep 29, 2019·PloS One·Jasmohan S BajajOliver Fiehn
Nov 2, 2016·Gut·Herbert TilgEmeran A Mayer
Nov 16, 2011·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Betti SchaeferClaus Peter Schmitt
Nov 17, 2016·International Journal of Hepatology·Abidullah KhanWazir Mohammad Khan
Jul 12, 2019·World Journal of Hepatology·Daniela CampionCarlo Alessandria
Jan 1, 2021·Gut Microbes·Fangcong Dong, Gary H Perdew
Jan 21, 2021·Journal of Clinical Medicine·Lorenzo Ridola, Oliviero Riggio
May 21, 2020·Journal of Agricultural and Food Chemistry·Jie ShiChunbao Li

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