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

Romeiro, Fernando Gomes [UNESP]; Ietsugu, Marjorie do Val [UNESP]; Franzoni, Letícia de Campos [UNESP]; Augusti, Laís [UNESP]; Alvarez, Matheus [UNESP]; Santos, Lívia Alves Amaral [UNESP]; Lima, Talles Bazeia [UNESP]; Koga, Kátia Hiromoto [UNESP]; Moriguchi, Sônia Marta [UNESP]; Caramori, Carlos Antonio [UNESP]; Silva, Giovanni Faria [UNESP]; Betting, Luiz Eduardo Gomes Garcia [UNESP]

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

Arquivos

2-s2.0-85046623102.pdf (1.32 MB)

Data

2018-01-01

Autores

Romeiro, Fernando Gomes

Ietsugu, Marjorie do Val

Franzoni, Letícia de Campos

Augusti, Laís

Alvarez, Matheus

Santos, Lívia Alves Amaral

Lima, Talles Bazeia

Koga, Kátia Hiromoto

Moriguchi, Sônia Marta

Caramori, Carlos Antonio

Tipo

Artigo

Direito de acesso

Acesso aberto

Resumo

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.