Hepatic encephalopathy(HE)remains a significant neuropsychiatric complication of liver disease,characterized by a spectrum of cognitive,behavioral,and motor impairments.Recent advances in the understanding of its path...Hepatic encephalopathy(HE)remains a significant neuropsychiatric complication of liver disease,characterized by a spectrum of cognitive,behavioral,and motor impairments.Recent advances in the understanding of its pathophysiology have identified inflammation and gut-liver-brain axis interactions along with conventional theories on ammonia toxicity.Rifaximin and lactulose continue to be the first-line therapies.However,novel approaches like ammonia-lowering agents such as glycerol phenylbutyrate,ornithine phenylacetate,zinc and L-ornithine Laspartate,gut microbiota modulation by probiotics,fecal microbiota transplantation,and anti-inflammatory drugs like rifamycin and its analogs started showing promising results in clinical trials.This review emphasizes the importance of a multidisciplinary approach in HE management,combining traditional and innovative therapies to enhance the patient’s quality of life and to reduce the healthcare burdens and also highlights the newer treatment strategies for future research and clinical application.展开更多
文摘Hepatic encephalopathy(HE)remains a significant neuropsychiatric complication of liver disease,characterized by a spectrum of cognitive,behavioral,and motor impairments.Recent advances in the understanding of its pathophysiology have identified inflammation and gut-liver-brain axis interactions along with conventional theories on ammonia toxicity.Rifaximin and lactulose continue to be the first-line therapies.However,novel approaches like ammonia-lowering agents such as glycerol phenylbutyrate,ornithine phenylacetate,zinc and L-ornithine Laspartate,gut microbiota modulation by probiotics,fecal microbiota transplantation,and anti-inflammatory drugs like rifamycin and its analogs started showing promising results in clinical trials.This review emphasizes the importance of a multidisciplinary approach in HE management,combining traditional and innovative therapies to enhance the patient’s quality of life and to reduce the healthcare burdens and also highlights the newer treatment strategies for future research and clinical application.
