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.