ReviewJournal of clinical and experimental hepatology2015
Pathogenesis of hepatic encephalopathy: role of ammonia and systemic inflammation.
Review in Journal of clinical and experimental hepatology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 164 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
164 citing papers in PubMed, 7 syntheses or guidelines pooled it, 298 citations in OpenAlex.
- Gut Microbiome in Patients with Chronic Kidney Disease Stages 4 and 5: A Systematic Literature Review.International journal of molecular sciences · 2025Pooled it
- Sarcopenia is a risk factor for post-transjugular intrahepatic portosystemic shunt hepatic encephalopathy and mortality: A systematic review and meta-analysis.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Pooled it
- Non-alcoholic Fatty Liver Disease: Also a Disease of the Brain? A Systematic Review of the Preclinical Evidence.Neurochemical research · 2024Pooled it
- Correlation of ammonia and blood laboratory parameters with hepatic encephalopathy: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Polyethylene glycol versus lactulose in the treatment of hepatic encephalopathy: a systematic review and meta-analysis.BMJ open gastroenterology · 2021Pooled it
- Chinese guidelines on management of hepatic encephalopathy in cirrhosis.World journal of gastroenterology · 2019Guideline
- Zinc supplementation in patients with cirrhosis and hepatic encephalopathy: a systematic review and meta-analysis.Nutrition journal · 2019Pooled it
- Resveratrol in Patients with Minimal Hepatic Encephalopathy.Nutrients · 2018Trial
- High Doses of N-Acetyl-P-Aminophenol Cause Acute Changes in Electroencephalographic and Electrocardiographic Activities in Wistar Rats.Basic & clinical pharmacology & toxicology · 2026Article
- Hyperuricemia increases susceptibility to chronic kidney injury exacerbation via autophagic flux blockade-mediated ammonia death pathway.Journal of advanced research · 2026Article
- [Pathogenic mechanisms and advances in the diagnosis and treatment of co-occurring psychiatric and psychological symptoms in patients with liver cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Pycnogenol attenuates thioacetamide-induced neurobehavioral impairment and hepatotoxicity via multi-target molecular modulation.BMC pharmacology & toxicology · 2026Article
- Extracellular vesicles from plasma of patients with minimal hepatic encephalopathy induce neuroinflammation and cognitive impairment in rats, which are prevented by treating the patients with rifaximin.Journal of neuroinflammation · 2026Article
- Liver-nervous system axis: pathways, dysregulation, and translational perspectives.Journal of neuroinflammation · 2026Review
- A Novel Use of Tenapanor in Patients With Hepatic Encephalopathy: A Case Series.ACG case reports journal · 2026Article
- Perioperative assessment of electroencephalography in dogs with congenital portosystemic shunts.Journal of veterinary internal medicine · 2026Article
- High-protein feed elevates ruminal and plasma ammonia and is associated with altered open-field behavior in Suffolk sheep.Frontiers in veterinary science · 2026Article
- Continuation of sedative infusions during palliative extubation for refractory status epilepticus in hepatic encephalopathy: A case report.SAGE open medical case reports · 2026Article
- A Prognostic Model Based on Immune-Inflammatory-Nutritional Indicators for 28-Day Mortality in Sepsis Patients with Acute-on-Chronic Liver Failure.Journal of inflammation research · 2026Article
- Neutrophil immunometabolism in ACLF and sepsis: mechanisms, dysfunction, and therapeutic opportunities.Frontiers in immunology · 2026Review
104 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The syndrome we refer to as Hepatic Encephalopathy (HE) was first characterized by a team of Nobel Prize winning physiologists led by Pavlov and Nencki at the Imperial Institute of Experimental Medicine in Russia in the 1890's. This focused upon the key observation that performing a portocaval shunt, which bypassed nitrogen-rich blood away from the liver, induced elevated blood and brain ammonia concentrations in association with profound neurobehavioral changes. There exists however a spectrum of metabolic encephalopathies attributable to a variety (or even absence) of liver hepatocellular dysfunctions and it is this spectrum rather than a single disease entity that has come to be defined as HE. Differences in the underlying pathophysiology, treatment responses and outcomes can therefore be highly variable between acute and chronic HE. The term also fails to articulate quite how systemic the syndrome of HE can be and how it can be influenced by the gastrointestinal, renal, nervous, or immune systems without any change in background liver function. The pathogenesis of HE therefore encapsulates a complex network of interdependent organ systems which as yet remain poorly characterized. There is nonetheless a growing recognition that there is a complex but influential synergistic relationship between ammonia, inflammation (sterile and non-sterile) and oxidative stress in the pathogenesis HE which develops in an environment of functional immunoparesis in patients with liver dysfunction. Therapeutic strategies are thus moving further away from the traditional specialty of hepatology and more towards novel immune and inflammatory targets which will be discussed in this review.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.