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02-04-2024 | Liver and Bile Duct Disease | Review

Liver and Brain Disorders

Authors: Akash Roy, Uday Chand Ghoshal, Mahesh K. Goenka

Published in: Current Hepatology Reports

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Abstract

Purpose of Review

This review provides a concise update on recent developments in liver and brain interactions traversing encephalopathy in acute, acute on chronic liver failure, and non-cirrhotic liver disease.

Recent Findings

An interconnected axis of gut-microbiota changes, systemic inflammation, and mediators of neuroinflammation impact liver-brain interaction. Encephalopathy in acute on chronic liver failure has its own trajectories. Newer drugs and techniques show promise, while established therapies have newer indications.

Summary

Neurogliovascular unit dysfunction and cross-talk abnormalities play an important role in brain dysfunction in liver disease. Ammonia is central to pathogenesis and has different implications in different settings of liver failure (acute/chronic/acute on chronic). Beyond cirrhosis, neurological dysfunction is common in non-cirrhotic portal hypertension, chronic viral hepatitis, and metabolic dysfunction associated steatotic liver disease. Newer therapies are promising, and future research should focus on further refinement of the pathophysiological basis for targeted therapies according to the type of encephalopathy.
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Metadata
Title
Liver and Brain Disorders
Authors
Akash Roy
Uday Chand Ghoshal
Mahesh K. Goenka
Publication date
02-04-2024
Publisher
Springer US
Published in
Current Hepatology Reports
Electronic ISSN: 2195-9595
DOI
https://doi.org/10.1007/s11901-024-00668-1
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