The effects of leucine versus isoleucine in the treatment of hepatic encephalopathy, according to the nutritional status of cirrhotic patients: a randomized, double blind controlled trial

• Grant number: 13/15121-8
• Support Opportunities: Scholarships in Brazil - Master
• Start date: October 01, 2013
• End date: February 28, 2015
• Field of knowledge: Health Sciences - Nutrition - Dietetics
• Principal Investigator: Carlos Antonio Caramori
• Grantee: Lais Augusti
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Hepatic encephalopathy (HE) is recognized as a neuropsychiatric disorder resulting from complications of liver failure. In cirrhotic patients, the prevalence of HE is 30-45% and it is estimated that the survival of these patients is only 42%. The muscle depletion in cirrhotic individuals reaches 65-90% of these patients and is directly related to the development of HE, the hyperammonaemia and mortality rates. Given the lack of progress in the treatment of HE and the concern about the loss of muscle mass in these patients, now one of the alternatives that have been shown to be more beneficial in clinical practice is the use of branched chain amino acids (BCAA), composed of leucine , isoleucine and valine, which besides the muscle mass gain contribuition, also contributes to the clinical improvement of HE, reducing morbidity and mortality. Among the BCAA, leucine is considered the most important, it is responsible for muscle protein synthesis and liver regeneration, so its supplementation alone may have the same effect of supplementation with all the BCAA. Furthermore, a recent study showed isoleucine concentrations below normal in cirrhotic patients with HE, suggesting that the lack of this amino acid plays an important role in HE. The objective of this project is to evaluate the effect of supplementation with leucine or with isoleucine in the improvement of HE. muscle mass gain, reduction of ammonia, and in the increase of serum albumin in cirrhotic patients with episodes of HE, according to their body composition through a prospective, randomized, double-blind, controlled study, comparing directly the effects of both types of supplements (leucine and isoleucine). (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

ROMEIRO, FERNANDO GOMES; IETSUGU, MARJORIE DO VAL; FRANZONI, LETICIA DE CAMPOS; AUGUSTI, LAIS; ALVAREZ, MATHEUS; AMARAL SANTOS, LIVIA ALVES; LIMA, TALLES BAZEI; KOGA, KATIA HIROMOTO; MORIGUCHI, SONIA MARTA; CARAMORI, CARLOS ANTONIO; et al. Which of the branched-chain amino acids increases cerebral blood flow in hepatic encephalopathy? A double-blind randomized trial. NEUROIMAGE-CLINICAL, v. 19, p. 302-310, 2018. (14/22572-9, 16/07117-9, 13/15121-8, 13/11761-2)

ROMEIRO, FERNANDO GOMES; AUGUSTI, LAIS. Nutritional assessment in cirrhotic patients with hepatic encephalopathy. WORLD JOURNAL OF HEPATOLOGY, v. 7, n. 30, p. 2940-2954, DEC 28 2015. (13/15121-8, 13/11761-2)

AUGUSTI, L.; FRANZONI, L. C.; SANTOS, L. A. A.; LIMA, T. B.; IETSUGU, M. V.; KOGA, K. H.; MORIGUCHI, S. M.; BETTING, L. E.; CARAMORI, C. A.; SILVA, G. F.; et al. Lower values of handgrip strength and adductor pollicis muscle thickness are associated with hepatic encephalopathy manifestations in cirrhotic patients. METABOLIC BRAIN DISEASE, v. 31, n. 4, p. 909-915, AUG 2016. (13/15121-8, 13/11761-2)

Academic Publications

(References retrieved automatically from State of São Paulo Research Institutions)

AUGUSTI, Lais. Assessment of nutritional status, protein intake and quality of life in cirrhotic patients with hepatic encephalopathy. 2015. Master's Dissertation - Universidade Estadual Paulista (Unesp). Faculdade de Medicina. Botucatu Botucatu.