ReviewJHEP reports : innovation in hepatology2021
The neurogliovascular unit in hepatic encephalopathy.
Review in JHEP reports : innovation in hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers.
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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.
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Who cites it
50 citing papers in PubMed, 74 citations in OpenAlex.
- Revisiting gut microbiota-driven ammonia metabolism: from disease burden to physiological adaptation.Gut microbes · 2026Review
- Covert hepatic encephalopathy as a multi-organ syndrome: the gut-liver-muscle-brain axis, diagnosis, treatment, and multidisciplinary care.Journal of gastroenterology · 2026Review
- Uncovering immune dysfunction in ACLF: Cellular mechanisms, molecular pathways, and therapeutic frontiers.Journal of hepatology · 2026Review
- Liraglutide Attenuates Multiorgan Oxidative, Astroglial, and Mitochondrial Stress Responses in Thioacetamide-Induced Hepatic Encephalopathy.International journal of molecular sciences · 2026Article
- Choroid plexus cyst burden is associated with glymphatic dysfunction and cognitive impairment in hepatic encephalopathy.Hepatology communications · 2026Article
- Covert hepatic encephalopathy in cirrhosis: implications for early diagnosis and appropriate management.Clinical journal of gastroenterology · 2026Review
- Association of the Albumin-Bilirubin score with 7-day incident delirium risk following bloodstream infection in critically ill adults: evidence from a propensity-weighted cohort.BMC infectious diseases · 2026Article
- Adiponectin Inhibits Oxidative Stress and Tight Junction Protein Loss: Evidence from a Hepatic Encephalopathy Mouse Model and Brain Endothelial Cells.Pharmaceuticals (Basel, Switzerland) · 2026Article
- [Hepatic encephalopathy from cholangitis in a young patient with ornithine transcarbamylase mutation].Revista medica del Instituto Mexicano del Seguro Social · 2026Article
- Gut microbiome and bile acid metabolism in liver disease: Mechanisms, clinical implications, and therapeutic opportunities.Pharmacological reviews · 2026Review
- Navigating TIPS in the era of ageing and metabolic comorbidity: a contemporary narrative review of risk, resilience, and outcomes.Gastroenterology report · 2026Review
- Novel insights into cyanobacterial (microcystins) neurotoxicity in rats: hepatic encephalopathy.Archives of toxicology · 2026Article
- Mechanistic insights into the liver-brain axis during chronic liver disease.Nature reviews. Gastroenterology & hepatology · 2026Review
- From Liver to Brain: A 2.5D Deep Learning Model for Predicting Hepatic Encephalopathy Using Opportunistic Non-contrast CT in Hepatitis B Related Acute-on-Chronic Liver Failure Patients.Journal of imaging informatics in medicine · 2026Article
- Neurofilament light chain proteins are a sensitive biomarker of neuronal damage in cirrhotic patients with hepatic encephalopathy.Frontiers in molecular biosciences · 2026Article
- S100B in brain-gut-liver crosstalk: from glial activation to multiorgan inflammation.Frontiers in immunology · 2026Review
- Prospective evaluation of speech as a digital biomarker for covert hepatic encephalopathy.NPJ digital medicine · 2025Article
- Uric acid and ammonia play synergistic roles in the loss of blood-brain barrier integrity in the context of hepatic encephalopathy.Fluids and barriers of the CNS · 2025Article
- MiR-33-5p-opioidergic Signaling Regulates Cognitive Impairment Induced by Bile Duct Ligation in Rats: Ameliorative Role of Naloxone.Brain and behavior · 2025Article
- Brain Changes in Alcohol Induced Liver Cirrhosis Patients: Insights from Quantitative Susceptibility Mapping.Biomedicines · 2025Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hepatic encephalopathy (HE) is a neurological complication of hepatic dysfunction and portosystemic shunting. It is highly prevalent in patients with cirrhosis and is associated with poor outcomes. New insights into the role of peripheral origins in HE have led to the development of innovative treatment strategies like faecal microbiota transplantation. However, this broadening of view has not been applied fully to perturbations in the central nervous system. The old paradigm that HE is the clinical manifestation of ammonia-induced astrocyte dysfunction and its secondary neuronal consequences requires updating. In this review, we will use the holistic concept of the neurogliovascular unit to describe central nervous system disturbances in HE, an approach that has proven instrumental in other neurological disorders. We will describe HE as a global dysfunction of the neurogliovascular unit, where blood flow and nutrient supply to the brain, as well as the function of the blood-brain barrier, are impaired. This leads to an accumulation of neurotoxic substances, chief among them ammonia and inflammatory mediators, causing dysfunction of astrocytes and microglia. Finally, glymphatic dysfunction impairs the clearance of these neurotoxins, further aggravating their effect on the brain. Taking a broader view of central nervous system alterations in liver disease could serve as the basis for further research into the specific brain pathophysiology of HE, as well as the development of therapeutic strategies specifically aimed at counteracting the often irreversible central nervous system damage seen in these patients.
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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.