Effects of Sorbent Suspension Dialysis on Plasma Amino Acid Levels in Cirrhotic Patients with Refractory Hepatic Encephalopathy

2002 ◽  
Vol 25 (10) ◽  
pp. 923-928 ◽  
Author(s):  
E. Bauer ◽  
A. Gendo ◽  
C. Madl ◽  
F. Garo ◽  
E. Roth ◽  
...  
Keyword(s):  
Amino Acids ◽  
Hepatic Encephalopathy ◽  
Amino Acid ◽  
Medical Treatment ◽  
Aromatic Amino Acids ◽  
Plasma Amino Acid ◽  
Clinical Grade ◽  
Cirrhotic Patients ◽  
Amino Acid Levels ◽  
Branched Chain

In cirrhotic patients, plasma amino acid levels are severely deranged. A decreased ratio of branched-chain to aromatic amino acids (Fischer ratio) has been implicated in the pathogenesis of hepatic encephalopathy. In this prospective study, we investigated the effects of extracorporeal detoxification on amino acid levels using a sorbent suspension dialysis system. Twenty patients with documented cirrhosis and hepatic encephalopathy grade II-III not responding to standard treatment were randomized to receive either six hours of sorbent dialysis and standardized conventional medical treatment or ongoing medical treatment alone. In contrast to previous uncontrolled studies, no significant effect on amino acid levels, Fischer ratio or clinical grade of hepatic encephalopathy was detected in either treatment group. In conclusion, a 6-hour treatment with sorbent dialysis did not significantly influence plasma levels of amino acids and did not ameliorate the clinical grade of hepatic encephalopathy.

A Comparison of the Effects of Intravenous Infusion of Individual Branched-Chain Amino Acids on Blood Amino Acid Levels in Man

1981 ◽  
Vol 60 (1) ◽  
pp. 95-100 ◽  
Author(s):  
S. Eriksson ◽  
L. Hagenfeldt ◽  
J. Wahren
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Intravenous Infusion ◽  
Serum Insulin ◽  
Aromatic Amino Acids ◽  
Branched Chain Amino Acids ◽  
Blood Concentrations ◽  
Branched Chain Amino Acid ◽  
Amino Acid Levels ◽  
Branched Chain

1., Intravenous infusions of l-valine (600 μmol/min), l-isoleucine (150 μmol/min), l-leucine (300 μmol/min) and a mixture of the three branched-chain amino acids (70% l-leucine, 20% l-valine, 10% l-isoleucine; 270 μmol/min) were given to four groups of healthy volunteer subjects. Whole-blood concentrations of amino acids and glucose and serum insulin were measured before and during the infusions. 2. Valine and isoleucine infusions resulted in twelve- and six-fold increases in the respective amino acid. During valine infusion, tyrosine was the only amino acid for which a decrease in concentration was seen (25%, P < 0.05). With isoleucine administration, no significant changes were found. In contrast, leucine infusion (during which the leucine concentration rose about sixfold) was accompanied by significant decreases in tyrosine (35%), phenylalanine (35%), methionine (50%), valine (40%) and isoleucine (55%). The arterial glucose concentration fell slightly (5%) and the insulin concentration increased 20% during leucine infusion. 3. Infusion of the mixture of the three branched-chain amino acids resulted in marked decreases in tyrosine (50%), phenylalanine (50%) and methionine (35%). The decreased amino acid levels remained low for 2 h after the end of the infusion. 4. The present findings demonstrate that intravenous infusion of leucine (not infusion of valine or isoleucine) results in marked reductions in the concentrations of the aromatic amino acids and methionine. Infusion of a mixture of the three branched-chain amino acids gives results similar to those obtained with leucine infusion alone. Thus a mixed branched-chain amino acid solution with leucine as its main constituent seems to be the best alternative in the treatment of patients with hepatic cirrhosis and encephalopathy.

Effect of Hemodiabsorption and Sorbent-Based Pheresis on Amino Acid Levels in Hepatic Failure

2000 ◽  
Vol 23 (6) ◽  
pp. 375-388 ◽  
Author(s):  
J. Steczko ◽  
K.C. Bax ◽  
S.R. Ash
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Hepatic Failure ◽  
High Performance ◽  
Aromatic Amino Acids ◽  
Dialysis Unit ◽  
Amino Acid Profiles ◽  
Amino Acid Levels ◽  
Pre Treatment ◽  
Branched Chain

Changes in plasma amino acid concentrations were measured in patients with hepatic failure during extracorporeal hemodiabsorption (using the Liver Dialysis Unit, “the Unit”) or hemodiabsorption plus sorbent-based pheresis treatment (using the Liver Dialysis Plasmafilter Unit, “the PF-Unit”) Systems. Eight patients with hepatic failure, grade 3 or 4 encephalopathy, elevated bilirubin and/or creatinine levels and respiratory or renal failure were treated for 1–3 days with the Unit alone. Three of these were also treated with the Unit containing 10 g of BCAA in the sorbent suspension. Four patients with hepatic failure treated with the PF Unit also had 10 g of branched chain amino acid (BCAA) added to the sorbents of the Unit portion of this device. Pre- and post-plasma samples were drawn and high performance liquid chromatography (HPLC) was used to separate and detect amino acids in the plasma. Both the Unit and the PF-Unit have the capability to selectively remove various amino acids, especially aromatic amino acids (AAA). The pre-treatment amino acid profiles of plasma were typical for hepatic failure, with abnormally high levels of phenylalanine, tyrosine, tryptophan, and methionine and decreased levels of valine, leucine and isolucine. The average pre-treatment Fischer ratio (BCAA/AAA) for both Unit and PF-Unit patients was 1.43 (±0.58). Treatments by both systems resulted in an increase of BCAA levels in blood and concomitant decrease of AAA levels, with an average Fischer ratio improvement of 30–38% for the Unit and PF-Unit without BCAA. The Fischer ratio improved by 90% (average) for the Unit with BCAA. Levels of many other amino acids (such as alanine, glycine, proline or lysine) increased during both Unit and PF-Unit treatments. The removal of strongly protein-bound toxin and amino acids such as tryptophan and sulphydryl amino acids was more effective by the PF-Unit. Both the Unit and the PF-Unit have the unique capability to remove toxic aromatic amino acids while increasing BCAA levels in patient. The increase in many amino acid levels may be related to the removal of toxins that interfere with normal amino acid metabolism. The addition of the PF module improves the removal of bilirubin and similarly protein-bound chemicals. Changes in amino acid profiles by the Unit and the PF-Unit contrast markedly with other extracorporeal devices.

scholarly journals Long-Term Carbohydrate-Containing Late-Evening Snack Significantly Improves the Ratio of Branched Chain Amino Acids to Aromatic Amino Acids in Adults with Liver Cirrhosis due to Hepatitis B

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Wei Hou ◽  
Zheng Lv ◽  
Jing Yang ◽  
Jing Wu ◽  
Zhong-ying Wang ◽  
...  
Keyword(s):  
Amino Acids ◽  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Amino Acid ◽  
Aromatic Amino Acids ◽  
Branched Chain Amino Acids ◽  
Plasma Amino Acid ◽  
Amino Acid Profiles ◽  
Late Evening ◽  
Branched Chain

Background. The liver is the primary organ for amino acid metabolism, and metabolic disorder of amino acids is common in liver disease. However, the characteristics of plasma amino acid profiles in patients with HBV-related cirrhosis and the impacts of late-evening snack (LES) on cirrhosis are unclear. Objectives. To investigate the characteristics of plasma amino acid profiles in patients with HBV-related chronic hepatitis, cirrhosis, and the effects of late-evening snacks on plasma amino acid profiles. Methods. 86 patients with HBV-related cirrhosis and eighty patients with chronic hepatitis B were included in this study. The plasma amino acid profiles were measured by the amino acid analyzer. Patients were randomly divided into two groups, of which the liver cirrhosis group was to receive daily LES ( n = 43 ) or non-LES ( n = 43 ) for 6 months. Plasma amino acid profiles and biochemical parameters were measured in both groups at baseline and after 1, 3, and 6 months. Results. Compared to healthy controls, the plasma concentration in the liver cirrhosis group of threonine, serine, glycine, glutamine, cysteine, tyrosine, phenylalanine, arginine, and methionine increased significantly ( P < 0.05 ), while the ratio of branched chain amino acids (BCAA) to aromatic amino acids (AAA) decreased significantly ( P < 0.05 ). A carbohydrate-predominant LES treatment resulted in a significant increase in BCAA/AAA and decrease in the level of ammonia and glutamine compared with baseline after 6 months of supplementation ( P < 0.05 ). Patients with Child-Pugh B and C are more responsive to changes in amino acid profiles than those with Child-Pugh A. Conclusions. The application of an LES carbohydrate module for six months in liver cirrhosis patients was associated with increased BCAA/AAA and decreased level of ammonia. Patients with Child-Pugh B and C grades were the most beneficial population.

Effect of free fatty acids on blood amino acid levels in human

1986 ◽  
Vol 250 (6) ◽  
pp. E686-E694 ◽  
Author(s):  
E. Ferrannini ◽  
E. J. Barrett ◽  
S. Bevilacqua ◽  
R. Jacob ◽  
M. Walesky ◽  
...  
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Plasma Insulin ◽  
Plasma Free Fatty Acid ◽  
Blood Levels ◽  
Experimental Conditions ◽  
Lipid Infusion ◽  
Amino Acid Levels ◽  
Branched Chain

Raised plasma free fatty acid (FFA) levels effectively impede glucose uptake in vivo, thereby conserving plasma glucose and sparing glycogen. To test whether FFA have any effect on blood amino acid levels, we infused Intralipid plus heparin or saline into healthy volunteers under four different experimental conditions: A) overnight fast; B) euglycemic hyperinsulinemia (approximately 100 microU/ml); C) hyperglycemic (approximately 200 mg/100 ml) hyperinsulinemia (approximately 50 microU/ml); and D) hyperglycemic (approximately 300 mg/100 ml) normoinsulinemia (approximately 20 microU/ml). In the fasting state (A), lipid infusion was associated with lower blood levels of most amino acids, both branched chain and glucogenic. This effect, however, could not be ascribed to lipid infusion alone, because plasma insulin levels were also stimulated. The clamp studies (B, C, and D) allowed to assess the influence of lipid on blood amino acid levels at similar plasma insulin and glucose levels. It was thus observed that lipid infusion has a significant hypoaminoacidemic effect of its own under both euglycemic (B) and hyperglycemic (C) conditions; this effect involved many glucogenic amino acids (alanine, glycine, phenylalanine, serine, threonine, and cystine) but none of the branched-chain amino acids (leucine, isoleucine, and valine). In marked contrast, normoinsulinemic hyperglycemia (D), with or without lipid infusion, caused no change in the blood level of any measured amino acid. We conclude that lipid infusion has a hypoaminoacidemic action. We also suggest that this action is permitted by insulin and may involve specific metabolic interactions (e.g., reduced availability of glucose-derived pyruvate or glycerophosphate) as well as enhanced uptake by the liver.

In Vitro adsorption Spectrum of Plasma Amino Acids by Coated Charcoal Hemoperfusion

1983 ◽  
Vol 6 (5) ◽  
pp. 267-270 ◽  
Author(s):  
Z.Q. Shi ◽  
T.M.S. Chang
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Hepatic Coma ◽  
Aromatic Amino Acids ◽  
Molar Ratio ◽  
Adsorption Experiment ◽  
Preferential Adsorption ◽  
Branched Chain ◽  
Charcoal Hemoperfusion

In order to clarify wether coated charcoal hemoperfusion is capable of normalizing amino acid disturbances in hepatic coma, in vitro adsorption and in vitro hemoperfusion studies were carried out. We have found that collodion-coated activated charcoal beads preferentially removed much more aromatic acids (AAA) than branched chain amino acids (BCAA). In the in vitro adsorption experiment with 50 μM amino acid standards aqueous solution, 99% of AAAs were removed by charcoal while only 50 to 81% of BCAAs were removed. As the concentration of amino acids in solution was doubled from μM to 100 μM, BCAA removal was halved while about 90% of AAA was still being removed. In vitro hemoperfusion with heparinized blood from hepatic failure rats, the clearance and the removal of AAAs were significantly greater than those of BCAAs. Consequently, the molar ratio of BCAA over AAA was markedly improved from the initial 1.09 to 3.87 after 60 min of hemoperfusion. Thus, we have demonstrated the preferential adsorption of aromatic amino acids by collodion-coated charcoal beads. The correction of BCAA/AAA molar ratio is also demonstrated.

scholarly journals Bolus ingestion of individual branched-chain amino acids alters plasma amino acid profiles in young healthy men

SpringerPlus ◽  
2014 ◽  
Vol 3 (1) ◽  
pp. 35 ◽  
Author(s):  
Takuya Matsumoto ◽  
Koichi Nakamura ◽  
Hideki Matsumoto ◽  
Ryosei Sakai ◽  
Tomomi Kuwahara ◽  
...  
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Branched Chain Amino Acids ◽  
Plasma Amino Acid ◽  
Healthy Men ◽  
Amino Acid Profiles ◽  
Branched Chain

scholarly journals Comparison of the effects of a high- and normal-casein breakfast on satiety, ‘satiety’ hormones, plasma amino acids and subsequent energy intake

2008 ◽  
Vol 101 (2) ◽  
pp. 295-303 ◽  
Author(s):  
Margriet A. B. Veldhorst ◽  
Arie G. Nieuwenhuizen ◽  
Ananda Hochstenbach-Waelen ◽  
Klaas R. Westerterp ◽  
Marielle P. K. J. Engelen ◽  
...  
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Energy Intake ◽  
Plasma Amino Acid ◽  
Plasma Amino Acids ◽  
Casein Protein ◽  
Ad Libitum ◽  
Glucagon Like Peptide 1 ◽  
Branched Chain ◽  
Amino Acid Concentrations

The present study compared the effects of a high- and normal-casein-protein breakfast on satiety, ‘satiety’ hormones, plasma amino acid responses and subsequent energy intake. Twenty-five healthy subjects (BMI 23·9 (sem 0·3) kg/m2; age 22 (sem 1) years) received a subject-specific standardised breakfast (20 % of daily energy requirements): a custard with casein as the single protein source with either 10, 55 and 35 (normal-casein breakfast) or 25, 55 and 20 (high-casein breakfast) % of energy (En%) from protein, carbohydrate and fat respectively in a randomised, single-blind design. Appetite profile (visual analogue scale; VAS), plasma glucose, insulin, glucagon-like peptide 1, ghrelin and amino acid concentrations were determined for 4 h; here the sensitive moment in time for lunch was determined. Subjects came for a second set of experiments and received the same custards for breakfast, and an ad libitum lunch was offered at 180 min after breakfast; energy intake was assessed. There were increased scores of fullness and satiety after the 25 En% casein-custard compared with the 10 En% casein-custard, particularly at 180 min (26 (sem 4) v. 11 (sem 5) mm VAS; P < 0·01) and 240 min (13 (sem 5) v. − 1 (sem 5) mm VAS; P < 0·01). This coincided with prolonged elevated plasma amino acid concentrations; total amino acids and branched-chain amino acids were higher after the 25 En% casein-custard compared with the 10 En% casein-custard at 180 and 240 min (P < 0·001). There was no difference in energy intake (3080 (sem 229) v. 3133 (sem 226) kJ for 25 En% and 10 En% respectively; NS) from the ad libitum lunch. In conclusion, a breakfast with 25 % of energy from casein is rated as being more satiating than a breakfast with 10 % of energy from casein at 3 and 4 h after breakfast, coinciding with prolonged elevated concentrations of plasma amino acids, but does not reduce subsequent energy intake.

Influence of plasma amino acid level on urine volume in the alligator

1962 ◽  
Vol 202 (1) ◽  
pp. 83-87 ◽  
Author(s):  
Roland A. Coulson ◽  
Thomas Hernandez
Keyword(s):  
Amino Acids ◽  
Growth Hormone ◽  
Amino Acid ◽  
Ammonia Synthesis ◽  
Amino Acid Level ◽  
Urine Volume ◽  
Plasma Amino Acid ◽  
Protein Catabolism ◽  
Degree Of Hydration ◽  
Amino Acid Levels

Growth hormone, hydrocortisone, and a mixture of the two were injected daily into small alligators for periods up to 2 weeks. Although plasma amino acid levels increased only slightly after either growth hormone or hydrocortisone, injection of the combined hormones doubled the concentrations. In all cases increases in plasma amino acids were associated with an augmented renal ammonia synthesis and an increased urine volume. When the degree of hydration was maintained at a nearly constant level, the urine volume was directly related to the quantity of amino acids available for renal deamination. Insulin, a hormone which lowers the concentration of extracellular amino acids, decreased the rate of renal ammonia synthesis and therefore the rate of urine flow. The oliguria produced by insulin could be counteracted by the injection of glycine, a known precursor of urinary ammonia. Evidence is presented which suggests that in the "diabetes" caused by a combined injection of growth hormone and hydrocortisone, protein catabolism is enhanced and fat catabolism is inhibited. A negative nitrogen balance occurred as a result of the delivery of more amino acids for renal deamination.

A COMPARISON OF THE EFFECT OF DIETARY FAT AND CARBOHYDRATE ON FREE AMINO ACIDS IN THEBLOOD PLASMA OF CHICKS

1967 ◽  
Vol 45 (2) ◽  
pp. 225-234 ◽  
Author(s):  
Tsang-Cheng Shao ◽  
D. C. Hill
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Dietary Fat ◽  
Free Amino Acids ◽  
Free Amino ◽  
Plasma Amino Acid ◽  
Considerable Time ◽  
Lower Plasma ◽  
Amino Acid Levels ◽  
Plasma Free Amino Acids

As previously reported, an increased concentration of plasma free amino acids, particularly lysine and threonine, was found when chicks were fasted for 24 hours. This increase was suppressed where a nonprotein diet was fed. Dextrose as the chief energy source in the nonprotein diet was more effective than shortening or lard in this respect. However, the degree to which the two energy sources differed was less where birds were adapted to the utilization of fat by feeding a diet rich in fat for a considerable time before making the comparison. Insulin administration to fasted chicks was found to lower plasma amino acid levels. The possible influence of interrelationships among dextrose, fat, and insulin on plasma amino acid levels is discussed.

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