Efficacy of oral L-ornithine L-aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy.

Abstract

Hyperammonemia and associated cerebral edema cause neurological abnormalities in liver disease patients. Although only 15% of ammonia production originates in the colon, management strategies for hepatic encephalopathy (HE) have focused on reducing ammonia generation from the bowel rather than on manipulating systemic mechanisms involved in ammonia metabolism. Administration of L-ornithine L-aspartate (LOLA) improves mental status and decreases serum and spinal fluid ammonia levels by stimulating both the urea cycle and glutamine (Gln) synthesis, which are key metabolic pathways in ammonia detoxification. LOLA was shown to be superior to a placebo for management of HE, and the results of several clinical trials suggest that its effectiveness could be higher with the more severe grades of this syndrome. Compared with the standard treatment, LOLA is effective not only in reducing hyperammonemia and the severity of this disease, but also in improving the patient's perceived quality of life. Therefore, LOLA is a promising alternative for the management of HE.

• Authors: Claudia Isabel Blanco Vela, Jorge Luis Poo Ramírez
• Journal: Annals of hepatology (Ann Hepatol) Vol. 10 Suppl 2 Pg. S55-9 (Jun 2011) ISSN: 1665-2681 [Print] Mexico
• PMID: 22228883 (Publication Type: Journal Article)

Chemical References

• Dipeptides
• Glutamine
• Ammonia
• Urea
• ornithylaspartate

Topics

• Administration, Oral
• Ammonia (metabolism)
• Dipeptides (administration & dosage, therapeutic use)
• Glutamine (metabolism)
• Hepatic Encephalopathy (drug therapy, etiology, metabolism)
• Humans
• Hyperammonemia (drug therapy, etiology, metabolism)
• Liver Cirrhosis (complications)
• Quality of Life
• Severity of Illness Index
• Treatment Outcome
• Urea (metabolism)