Which of the branched-chain amino acids increases cerebral blood flow in hepatic encephalopathy? A double-blind randomized trial

Author(s):Show less -

Romeiro, Fernando Gomes ^[1] ; Ietsugu, Marjorie do Val ^[1] ; Franzoni, Leticia de Campos ^[1] ; Augusti, Lais ^[1] ; Alvarez, Matheus ^[2] ; Amaral Santos, Livia Alves ^[1] ; Lima, Talles Bazei ^[1] ; Koga, Katia Hiromoto ^[3] ; Moriguchi, Sonia Marta ^[3] ; Caramori, Carlos Antonio ^[1] ; Silva, Giovanni Fari ^[1] ; Gomes Garcia Betting, Luiz Eduardo ^[4]

Affiliation

^[1] UNESP Univ Estadual Paulista, Botucatu Med Sch, Dept Internal Med, Av Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Botucatu, SP - Brazil

^[2] UNESP Univ Estadual Paulista, Dept Phys & Biophys, Botucatu Biosci Inst, Rua Prof Dr Antonio Celso Wagner Zanin S-N, BR-18618689 Botucatu, SP - Brazil

^[3] UNESP Univ Estadual Paulista, Botucatu Med Sch, Dept Trop Dis & Imaging Diag, Av Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Botucatu, SP - Brazil

^[4] UNESP Univ Estadual Paulista, Botucatu Med Sch, Dept Neurol Psychol & Psychiat, Av Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Botucatu, SP - Brazil

• Document type: Journal article
• Source: NEUROIMAGE-CLINICAL; v. 19, p. 302-310, 2018.
• Web of Science Citations: 1

Abstract

Branched-chain amino acids increase the brain perfusion of patients with hepatic encephalopathy (HE), but the amino acid and the mechanisms involved are still unknown. This study compared brain perfusion and clinical improvement during leucine or isoleucine supplementation. After randomization, 27 subjects with cirrhosis and HE received leucine or isoleucine supplements for one year. Brain single Photon Emission Computed Tomography (SPECT) and dynamic brain scintigraphy (DBS) were performed pretreatment and at 1, 8 and 12 months of supplementation. Brain perfusion was increased only in the isoleucine group at 8 months of treatment by both SPECT and DBS (p < 0.001 and p = 0.05, respectively) and by SPECT at the 12th month (p < 0.05). This was associated with hepatic encephalopathy improvement at 8 and 12 months (p = 0.008 and 0.004, respectively), which was not observed in the leucine group (p = 0.313 and 0.055, respectively). Isoleucine supplementation achieved a better impact on brain perfusion restoration in HE. (AU)

• FAPESP's process: 14/22572-9 - Bone changes in patients with liver cirrhosis treated for osteoporosis and osteopenia
• Grantee: Lívia Alves Amaral Santos
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 16/07117-9 - Risedronate for osteoporosis treatment in patients with liver cirrhosis and esophageal varices: assessment on safety profile and bone mass
• Grantee: Fernando Gomes Romeiro
• Support Opportunities: Regular Research Grants
• FAPESP's process: 13/15121-8 - 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
• Grantee: Lais Augusti
• Support Opportunities: Scholarships in Brazil - Master
• FAPESP's process: 13/11761-2 - Effect of isolated branched chain amino acids in the serum pH and cerebral blood flow of cirrhotic patients: a randomized, double blind controlled trial
• Grantee: Fernando Gomes Romeiro
• Support Opportunities: Regular Research Grants