I. Venturini et al., Ammonia and endogenous benzodiazepine-like compounds in the pathogenesis of hepatic encephalopathy, SC J GASTR, 36(4), 2001, pp. 423-425
Background: Ammonia and endogenous benzodiazepines (BDZs) are two of the mo
st important agents among those taken into consideration in the pathogenesi
s of hepatic encephalopathy (HE). Methods: Venous ammonia and endogenous BD
Zs sera levels were assayed in 58 liver cirrhosis patients (34 male, 24 fem
ale) free of commercial BDZs. Endogenous BDZs were measured by binding assa
y after highperformance liquid chromatography purification. Ammonia was ass
essed by colorimetric test. Results: Endogenous BDZs and ammonia were signi
ficantly higher in Child-Pugh class C than in class B and class A (P < 0.05
), correlating to the severity of the liver dysfunction but not with the de
gree of HE. A significant difference, in fact, was noted between degree 0 (
no HE) versus III-IV of HE (P < 0.05), but not between degrees I-II versus
III-IV. Regression analysis performed to find a correlation between the amm
onia and BDZ levels in HE resulted negative. Conclusion: Clinical evidence
is provided in cirrhotic patients that ammonia and endogenous BDZ levels do
not correlate with each other in the outcome of HE.