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Review
. 2022 Jan 26;11(3):611.
doi: 10.3390/jcm11030611.

Ammonia and the Muscle: An Emerging Point of View on Hepatic Encephalopathy

Simone Di Cola  1 , Silvia Nardelli  1 , Lorenzo Ridola  1 , Stefania Gioia  1 , Oliviero Riggio  1 , Manuela Merli  1
Affiliations
Review

Ammonia and the Muscle: An Emerging Point of View on Hepatic Encephalopathy

Simone Di Cola et al. J Clin Med. .

Abstract

In the last years the link between the presence of muscular alterations and hepatic encephalopathy (HE), both minimal and overt, has been deeply studied. The pathophysiological background supporting the relationship between muscle depletion, and HE is characterized by an imbalance between the capacity of muscle in ammonia metabolism and trafficking and the inability of the liver in removing ammonia through urea synthesis due to liver failure and/or the presence of porto-systemic shunts. This review will focus on the clinical burden, the physio pathological mechanisms understanding the liver muscle axis and principles of management of muscular alterations in cirrhosis.

Keywords: cirrhosis; hepatic encephalopathy; myosteatosis; sarcopenia.

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Conflict of interest statement

The authors declare no conflict of interest.

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