UCL Institute of Hepatology, Division of Medicine, University College London, London, UK.
Liver Int. 2011 Feb;31(2):163-75. doi: 10.1111/j.1478-3231.2010.02302.x.
Hepatic encephalopathy complicates the course of both acute and chronic liver disease and its treatment remains an unmet clinical need. Ammonia is thought to be central in its pathogenesis and remains an important target of current and future therapeutic approaches. In liver failure, the main detoxification pathway of ammonia metabolism is compromised leading to hyperammonaemia. In this situation, the other ammonia-regulating pathways in multiple organs assume important significance. The present review focuses upon interorgan ammonia metabolism in health and disease describing the role of the key enzymes, glutamine synthase and glutaminase. Better understanding of these alternative pathways are leading to the development of new therapeutic approaches.
肝性脑病使急性和慢性肝病的病程复杂化，其治疗仍然是一个未满足的临床需求。氨被认为在其发病机制中起核心作用，仍然是当前和未来治疗方法的重要靶点。在肝功能衰竭中，氨代谢的主要解毒途径受损，导致高氨血症。在这种情况下，多个器官中的其他氨调节途径具有重要意义。本综述重点关注健康和疾病中的器官间氨代谢，描述关键酶谷氨酰胺合成酶和谷氨酰胺酶的作用。对这些替代途径的更好理解正在导致新的治疗方法的发展。
