Deshpande Gautam, Adachi Naoto, Liu Keyue, Motoki Atsuko, Mitsuyo Toshihiko, Nagaro Takumi, Arai Tatsuru
Department of Internal Medicine, University of California-San Diego, San Diego, CA, USA.
J Neurosurg Anesthesiol. 2007 Oct;19(4):243-8. doi: 10.1097/ANA.0b013e31811ecdf6.
A decrease in the serum ratio of branched-chain amino acids (BCAAs) to aromatic amino acids (Fischer ratio) reflects the severity of hepatic encephalopathy, and clinical improvement by dietary augmentation with BCAAs has been demonstrated. As behavioral alteration results from changes in central neurotransmission, we investigated the role of BCAA administration on changes in the levels of central neurotransmitters in acute liver injury. Male Wistar rats were subjected to liver ischemia by occluding the left portal vein and hepatic artery for 90 minutes. A 4% BCAA solution containing valine, leucine, and isoleucine was intraperitoneally administered 3 times (8 mL/kg, each) at 1 hour, 6 hours, and 24 hours after vascular reperfusion, and changes in the extracellular concentrations of neurotransmitter amino acids, monoamines, and their metabolites were evaluated in the striatum by a microdialysis procedure. Although the extracellular concentration of dopamine was affected by neither liver ischemia nor BCAA injections, the level of 3,4-dihydroxyphenylacetic acid, a metabolite of dopamine, decreased to 34% in the ischemic group 24 hours after reperfusion. The 3,4-dihydroxyphenylacetic acid level was normalized by treatments with BCAAs. The improvement of deranged cerebral dopaminergic activity may be a contributing factor in the improvement of hepatic encephalopathy by BCAAs.
血清中支链氨基酸(BCAAs)与芳香族氨基酸的比例降低(费希尔比率)反映了肝性脑病的严重程度,并且已证明通过补充BCAAs饮食可实现临床改善。由于行为改变是由中枢神经传递的变化引起的,我们研究了给予BCAAs对急性肝损伤中枢神经递质水平变化的作用。雄性Wistar大鼠通过阻断左门静脉和肝动脉90分钟来诱导肝缺血。在血管再灌注后1小时、6小时和24小时,腹腔内注射含缬氨酸、亮氨酸和异亮氨酸的4% BCAA溶液3次(每次8 mL/kg),并通过微透析程序评估纹状体中神经递质氨基酸、单胺及其代谢产物的细胞外浓度变化。尽管多巴胺的细胞外浓度不受肝缺血和BCAA注射的影响,但多巴胺的代谢产物3,4-二羟基苯乙酸的水平在再灌注后24小时的缺血组中降至34%。用BCAAs治疗可使3,4-二羟基苯乙酸水平恢复正常。脑多巴胺能活性紊乱的改善可能是BCAAs改善肝性脑病的一个促成因素。