Glutamine and Albumin Levels in Cerebrospinal Fluid Are Correlated with Neurological Severity in an Experimental Model of Acute Hepatic Encephalopathy.

BACKGROUND/OBJECTIVES: Hepatic encephalopathy (HE) is a severe neurological complication of acute liver failure (ALF) characterized by the accumulation of neurotoxic metabolites and impaired cerebral function. We aimed to examine the correlation between HE severity and cerebrospinal fluid (CSF) biomarker levels in a rat model of ALF induced by subtotal hepatectomy.

METHODS

Male Wistar rats underwent 92% hepatectomy and were monitored for neurological impairment via a standardized HE score. At twenty-four hours post surgery, CSF and blood were collected for biochemical analysis.

RESULTS

We found a significant positive correlation between neurological severity and CSF levels of glutamine (r = 0.929, < 0.001) and albumin (r = 0.869, < 0.001), both with HE grade I scores, highlighting their prominent role as HE biomarkers. Other amino acids, including aspartate (r = 0.790, < 0.001), glutamate (r = 0.853, < 0.001), isoleucine (r = 0.834, < 0.001), leucine (r = 0.813, < 0.001), lysine (r = 0.861, < 0.001), methionine (r = 0.889, < 0.001), phenylalanine (r = 0.916, < 0.001), ornithine (r = 0.775, < 0.001), tryptophan (r = 0.814, < 0.001), and valine (r = 0.721, < 0.001), also showed significant correlations with HE severity but not with HE grade I scores.

CONCLUSIONS

These findings underscore the potential of glutamine and albumin in CSF as key biomarkers for assessing neurological severity in ALF patients.