ReviewMetabolic brain disease2025
Ammonia and beyond - biomarkers of hepatic encephalopathy.
Review in Metabolic brain disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Effects of imbalanced gut microbial on mice with type a hepatic encephalopathy through the gut-liver-brain axis.Metabolic brain disease · 2026Article
- Neurofilament Light Chain in Cerebrospinal Fluid and Blood Identifies Patients With Minimal and Overt Hepatic Encephalopathy.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Development of a tryptophan metabolomics-based diagnostic model for hepatic encephalopathy in liver cirrhosis.European journal of medical research · 2026Article
- [Clinical research progress in 2025 for hepatic fibrosis, cirrhosis, and portal hypertension].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Article
- Neurofilament light chain proteins are a sensitive biomarker of neuronal damage in cirrhotic patients with hepatic encephalopathy.Frontiers in molecular biosciences · 2026Article
- Electroencephalography in hepatic encephalopathy: diagnostic and prognostic applications across the disease spectrum.Annals of gastroenterology · 2026Review
- Beyond Organ Boundaries: Molecular Mechanisms of Hepatic Encephalopathy and Parkinson's Disease from the Perspective of the Gut-Liver-Brain Axis.Research (Washington, D.C.) · 2026Review
- Metabolic dysfunction-associated steatotic liver disease alters brain function and behavior: Insights from liver-targeted siRNA therapy.Science advances · 2025Article
- Protective effect of artichoke (Cynara scolymus L.) leaf and receptaculum extracts against hepatic encephalopathy in bile duct ligated rats.Metabolic brain disease · 2025Article
- Gray matter microstructural alterations and their correlation with systemic biomarkers in hepatic encephalopathy: a NODDI study using gray-matter based spatial statistics.Frontiers in neurologyArticle
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Authors and funding
15 authors.
Funding
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Abstract
Ammonia is a product of amino acid metabolism that accumulates in the blood of patients with liver cirrhosis, leading to neurotoxic effects and hepatic encephalopathy (HE). HE manifestations can range from mild, subclinical disturbances in cognition, or minimal HE (mHE) to gross disorientation and coma, a condition referred to as overt HE. Many blood-based biomarkers reflecting these neurotoxic effects of ammonia and liver disease can be measured in the blood allowing the development of new biomarkers to diagnose cirrhosis patients at risk of developing HE. The effect of ammonia on the brain is modulated by severity of systemic inflammation, and both hyperammonemia and inflammation can induce oxidative stress, which may mediate the neurological alterations associated to HE. This review aims to provide the latest evidence on biomarkers of HE beyond ammonia. We present different approaches to predict overt HE based on the combination of blood ammonia with some analytical and clinical parameters. Magnetic resonance analysis of brain images could also provide sensitive diagnostic biomarkers based on neuroimaging parameters. Some reports suggest that markers of systemic inflammation, oxidative stress, and central nervous system-derived components, may serve as additional biomarkers of HE. The involvement of extracellular vesicles and microbiota in the pathophysiology of mHE and HE has recently acquired importance and it would be interesting to explore their usefulness as early biomarkers of the disease. It is important to have a biomarker or a combination of them for early diagnosis of mHE to improve its treatment and prevent progression to overt HE.
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