Skip to main content

Alcohol, Amino Acids, and Encephalopathy

  • Chapter
Contemporary Metabolism

Abstract

Encephalopathy is a severe and common complication of cirrhosis, including alcoholic cirrhosis, but its pathogenesis is not fully understood. Several new theories have been proposed, and many have emphasized the importance of plasma amino acids. Recent studies have called into question the hypothesis that the ratio of aromatic to branched-chain amino acids in plasma is the key abonormality in this disorder.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Aguirre, A. L., Yoshimura, N., Westman, T., and Fischer, J. E., 1974, Plasma α-amino acids in dogs with two experimental forms of liver damage, J. Surg. Res. 16:339–345.

    Article  PubMed  CAS  Google Scholar 

  • Branchey, L., Shaw, S., and Lieber, C. S., 1981, Ethanol impairs tryptophan transport into the brain and depresses serotonins Life Sci. 29:2751–2755.

    Article  PubMed  CAS  Google Scholar 

  • Faraj, B. A., Bowen, P. A., Isaacs, J. W., and Rudman, D., 1976, Hypertyraminemia in cirrhotic patients, N. Engl. J. Med. 294:1360–1364.

    Article  PubMed  CAS  Google Scholar 

  • Faraj, B. A., Fulwider, J. T., Rypins, E. B., Nordlinger, B., Ivey, G. L., Jansen, R. D., Ali, F. M., Camp, V. M., Kutner, M., Schmidt, F., and Rudman, D., 1979, Tyramine kinetics and metabolism in cirrhosis, J. Clin. Invest. 64:413–420.

    Article  PubMed  CAS  Google Scholar 

  • Fernstrom, J. D., and Wurtman, R. J., 1972, Brain serotonin content: Physiological regulation by plasma neutral amino acids, Science 178:414–416.

    Article  PubMed  CAS  Google Scholar 

  • Finkelstein, J. D., and Kyle, W. E., 1968, Ethanol effects on methionine metabolism in rat liver, Proc. Soc. Exp. Biol. Med. 129:497–501.

    PubMed  CAS  Google Scholar 

  • Finkelstein, J. D., Cello, J. P., and Kyle, W. E., 1974, Ethanol induced changes in methionine metabolism in rat liver, Biochem. Biophys. Res. Commun. 61:525–531.

    Article  PubMed  CAS  Google Scholar 

  • Fischer, J. E., Yoshimura, N., Aguirre, A., James, J. H., Cummings, M. G., Abel, R. M., and Deindorfer, F., 1974, Plasma amino acids in patients with hepatic encephalopathy: Effects of amino acid infusions, Am. J. Surg. 127:40–47.

    Article  PubMed  CAS  Google Scholar 

  • Fischer, J. E., Funovics, J.M., Aguirre, A., James, J. H., Keane, J. M., Wesdorp, R. I. C., Yoshimura, N., Westman, T., 1975, The role of plasma amino acids in hepatic encephalopathy, Surgery 78:276–290.

    PubMed  CAS  Google Scholar 

  • Fischer, J. E., Rosen, H. M., Ebeid, A. M., James, J. H., Keane, J. M., and Soeters, P. B., 1976, The effect of normalization of plasma amino acids on hepatic encephalopathy in man, Surgery 80:77–91.

    PubMed  CAS  Google Scholar 

  • Holt, L. E., Snyderman, S. E., Norton, P. M., and Roitman, E., 1968, The plasma aminogram as affected by protein intake, in: Protein Nutrition and Free Amino Acid Patterns (J. H. Leathern, ed.), pp. 32–39, Rutgers University Press, New Brunswick, New Jersey.

    Google Scholar 

  • Hsu, J. M., 1979, Ethanol comsumption and free amino acids of rat plasma and liver, in: NIAAA Research Monograph 2: Alcohol and Nutrition (T.-K. Li, S. Schenker, and L. Lumeng, eds.), pp. 289–293, DHEW Publication (ADM) 79–780, U.S. Government Printing Office, Washington.

    Google Scholar 

  • Iber, F. L., Rosen, H., Levenson, S. M., and Chalmers, T. C., 1957, Plasma amino acids in patients with liver failure, J. Lab. Clin. Med. 50:417–425.

    PubMed  CAS  Google Scholar 

  • Ishii, H., Kanno, T., Shigeta, Y., Takagi, S., Yasurakka, S., Kano, S., Takeshita, E., and Tsuchiya, M., 1976, Hepatic gamma glutamyl transpeptidase (GGTP) activity: Its activation by chronic ethanol administration, Gastroenterology 71:913.

    Google Scholar 

  • Iwasaki, Y., Sato, H., Ohkubo, A., Sanjo, T., Futagawa, S., Sugiura, M., and Tsuji, S., 1980, Effect of spontaneous portal-systemic shunting on plasma insulin and amino acid concentrations, Gastroenterology 78:677–683.

    PubMed  CAS  Google Scholar 

  • James. H. J., Hodgman, J. M., Funovics, J. M., Yoshimura, N., and Fischer, J. E., 1976, Brain tryptophan, plasma free tryptophan and distribution of plasma neutral amino acids, Metabolism 25:471–476.

    Article  PubMed  CAS  Google Scholar 

  • Levine, R. J., and Conn, H. O., 1967, Tyrosine metabolism in patients with liver disease, J. Clin. Invest. 46:2012–2020.

    Article  PubMed  CAS  Google Scholar 

  • Morgan, M. Y., Milson, J. P., and Sherlock, S., 1978, Plasma ratio of valine, leucine and isoleucine to phenylalanine and tyrosine in liver disease, Gut 19:1068–1073.

    Article  PubMed  CAS  Google Scholar 

  • Ning, M., Lowenstein, L. M., and Davidson, C. S., 1967, Serum amino acid concentrations in alcoholic hepatitis, J. Lab. Clin. Med. 70:554–562.

    PubMed  CAS  Google Scholar 

  • Ono, J., Hutson, D. G., Dombro, R. S., Levi, J. U., Livingstone, A., and Zeppa, R., 1978, Tryptophan and hepatic coma, Gastroenterology 74:196–200.

    PubMed  CAS  Google Scholar 

  • Rosen, H. M., Yoshimura, N., Hodgman, J. M., and Fischer, J. E., 1977, Plasma amino acid patterns in hepatic encephalopathy of differing etiology, Gastroenterology 72:438–488.

    Google Scholar 

  • Shaw, S., and Lieber, C. S., 1975, Plasma amino acids in alcoholic liver injury: Contrast with protein malnutrition, Clin. Res. 23:459.

    Google Scholar 

  • Shaw, S., and Lieber, C. S., 1978, Plasma amino acid abnormalities in the alcoholic; respective role of alcohol, nutrition and liver injury, Gastroenterology 74:677–682.

    PubMed  CAS  Google Scholar 

  • Shaw, S., and Lieber, C. S., 1980, Increased hepatic production of alpha amino-n-butyric acid after chronic alcohol consumption in rats and baboons, Gastroenterology 78:108–113.

    PubMed  CAS  Google Scholar 

  • Shaw, S., and Lieber, C. S., 1980, Mechanism of increased gamma glutamyl transpeptidase after chronic alcohol consumption: Hepatic microsomal induction rather than dietary imbalance, Substance Alc. Actions Misuse 1:423–428.

    CAS  Google Scholar 

  • Shaw, S., Stimmel, B., and Lieber, C. S., 1976, Plasma alpha amino-n-butyric acid to leucine ratio: An empirical biochemical marker of alcoholism, Science 194:105710–58.

    Article  Google Scholar 

  • Shaw, S., Worner, T. M., Borysow, M. F., Schmitz, R. E., and Lieber C. S., 1979, Detection of alcoholic relapse: Comparative diagnostic value of MCV, GGTP and AANB, Alcoholism: Clin. Exp. Res. 3:297–301.

    Article  CAS  Google Scholar 

  • Sherwin, R., Joshi, P., Hendler, R., Felig, P., and Conn, H., 1974, Hyperglucagonemia in Laennec’s cirrhosis, N. Engl. J. Med. 290:239–242.

    Article  PubMed  CAS  Google Scholar 

  • Sies, H., Koch, O. R., Martino, E., and Boveris, A., 1979, Increased biliary glutathione disulfide release in chronically ethanol-treated rats, FEBS Lett. 103:287–290.

    Article  PubMed  CAS  Google Scholar 

  • Soeters, P. B., and Fischer, J. E., 1976, Insulin, glucagon, aminoacid imbalance and hepatic encephalopathy, Lancet 2:880–882.

    Article  PubMed  CAS  Google Scholar 

  • Stanko. R. T., Morse, E. L., and Adibi, S. A., 1979, Prevention of effects of ethanol on amino acid concentrations in plasma and tissues by hepatic lipotropic factors in rats, Gastroenterology 76:132–138.

    PubMed  CAS  Google Scholar 

  • Swendseid, M. E., Tuttle, S. G., Figueroa, W. S., Mulcare, D., Clark, A. J., and Massey, F. J., 1966, Plasma amino acid levels of men fed diets differing in protein content. Some observations with valine-deficient diets, J. Nutr. 88:239–248.

    PubMed  CAS  Google Scholar 

  • Swendseid, M. E., Yamada, C., Vinyard, E., and Figueroa, W. G., 1968, Plasma amino acid levels in young subjects receiving diets containing 14 or 3.5 grams nitrogen per day, Am. J. Clin. Nutr. 21:1381–1383.

    PubMed  CAS  Google Scholar 

  • Teschke, R., Brand, A., and Strohmeyer, G., 1977, Induction of hepatic microsomal gamma-glutamyltransferase activity following chronic alcohol consumption, Biochem. Biophys. Res. Commun. 75:718–724.

    Article  PubMed  CAS  Google Scholar 

  • Zinneman, H. H., Seal, U. S., and Doe, R. P., 1969, Plasma and urinary amino acids in Laennec’s cirrhosis, Am. J. Dig. Dis. 14:118–126.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1982 Plenum Publishing Corporation

About this chapter

Cite this chapter

Shaw, S., Lieber, C.S. (1982). Alcohol, Amino Acids, and Encephalopathy. In: Freinkel, N. (eds) Contemporary Metabolism. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-4187-1_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-4684-4187-1_5

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4684-4189-5

  • Online ISBN: 978-1-4684-4187-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics