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What is new about diet in hepatic encephalopathy.
Metab Brain Dis 2016; 31(6):1289-1294MB

Abstract

There is a relationship between hepatic encephalopathy (HE) protein malnutrition and muscle wasting. Muscle may play an alternative role in ammonia detoxification. Molecular mechanisms responsible for muscle depletion are under investigation. Specific nutrients may interact to reverse the molecular pathways involved in muscle wasting at an early stage. Training exercises have also been proposed to improve skeletal muscle mass. However, these data refer to small groups of patients. The amelioration of muscle mass may potentially help to prevent HE. The pathogenesis of HE is associated with modifications of the gut microbiota and diet is emerging to play a relevant role in the modulation of the gut milieu. Vegetarian and fibre-rich diets have been shown to induce beneficial changes on gut microbiota in healthy people, with reduction of Bacteroides spp., Enterobacteriaceae, and Clostridium cluster XIVa bacteria. By way of contrast, it has been suggested that a high-fat or protein diet may increase Firmicutes and reduce Bacteroidetes phylum. Milk-lysozyme and milk-oligosaccharides have also been proposed to induce a "healthy" microbiota. At present, no studies have been published describing the modification of the gut microbiota in cirrhotic patients with HE as a response to specific diets. New research is needed to evaluate the potentiality of foods in the modulation of gut microbiota in liver disease and HE.

Authors+Show Affiliations

Gastroenterology, Department of Clinical Medicine, "Sapienza" University of Rome, Rome, Italy. manuela.merli@uniroma1.it.Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy.Gastroenterology, Department of Clinical Medicine, "Sapienza" University of Rome, Rome, Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26419384

Citation

Merli, Manuela, et al. "What Is New About Diet in Hepatic Encephalopathy." Metabolic Brain Disease, vol. 31, no. 6, 2016, pp. 1289-1294.
Merli M, Iebba V, Giusto M. What is new about diet in hepatic encephalopathy. Metab Brain Dis. 2016;31(6):1289-1294.
Merli, M., Iebba, V., & Giusto, M. (2016). What is new about diet in hepatic encephalopathy. Metabolic Brain Disease, 31(6), pp. 1289-1294.
Merli M, Iebba V, Giusto M. What Is New About Diet in Hepatic Encephalopathy. Metab Brain Dis. 2016;31(6):1289-1294. PubMed PMID: 26419384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - What is new about diet in hepatic encephalopathy. AU - Merli,Manuela, AU - Iebba,Valerio, AU - Giusto,Michela, Y1 - 2015/09/29/ PY - 2015/07/30/received PY - 2015/09/15/accepted PY - 2015/10/1/pubmed PY - 2018/1/9/medline PY - 2015/10/1/entrez KW - Cirrhosis KW - Fibres KW - Gut microbiota KW - Nutrition KW - Sarcopenia KW - Vegetables SP - 1289 EP - 1294 JF - Metabolic brain disease JO - Metab Brain Dis VL - 31 IS - 6 N2 - There is a relationship between hepatic encephalopathy (HE) protein malnutrition and muscle wasting. Muscle may play an alternative role in ammonia detoxification. Molecular mechanisms responsible for muscle depletion are under investigation. Specific nutrients may interact to reverse the molecular pathways involved in muscle wasting at an early stage. Training exercises have also been proposed to improve skeletal muscle mass. However, these data refer to small groups of patients. The amelioration of muscle mass may potentially help to prevent HE. The pathogenesis of HE is associated with modifications of the gut microbiota and diet is emerging to play a relevant role in the modulation of the gut milieu. Vegetarian and fibre-rich diets have been shown to induce beneficial changes on gut microbiota in healthy people, with reduction of Bacteroides spp., Enterobacteriaceae, and Clostridium cluster XIVa bacteria. By way of contrast, it has been suggested that a high-fat or protein diet may increase Firmicutes and reduce Bacteroidetes phylum. Milk-lysozyme and milk-oligosaccharides have also been proposed to induce a "healthy" microbiota. At present, no studies have been published describing the modification of the gut microbiota in cirrhotic patients with HE as a response to specific diets. New research is needed to evaluate the potentiality of foods in the modulation of gut microbiota in liver disease and HE. SN - 1573-7365 UR - https://www.unboundmedicine.com/medline/citation/26419384/full_citation L2 - https://doi.org/10.1007/s11011-015-9734-5 DB - PRIME DP - Unbound Medicine ER -