Jane Missler1,2, Wenlei Jiang3, Dieter Leibfritz2, Claudia Zwingmann1
1Dpartement de mdicine, Centre de Recherche, Hpital Saint-Luc, Universit de Montral, Montral, Quebec, Canada; 2Department of Chemistry, University of Bremen, Bremen, Germany; 3Dpartement de mdicine , Centre de Recherche, Hpital Saint-Luc, Universit de Montral, Montral, Quebec, Canada
Hepatic Encephalopathy is associated with hyperammonemia and energetic changes in brain. In animal models and patients with mild HE, L-carnitine has been shown to be protective. In order to investigate the effect of L-carnitine on brain energy-metabolism, multinuclear NMR was used to measure metabolic pathways in brain following administration of [U-13C]glucose in ammonia-treated rats with PCA. In ammonia-precipitated encephalopathy, L-carnitine considerably delayed the time to coma, concomitantly to enhanced ammonia detoxification via astrocytic glutamine synthesis and attenuation of lactate accumulation. These results indicate to cell-specific actions of L-carnitine which might explain its therapeutic effect in ammonia-precipitated HE in cirrhotic patients.