Advance in mechanisms of astrocyte swelling in patients with hepatic encephalopathy

Abstract

Brain edema is a significant feature of hepatic encephalopathy due to acute liver failure. Chronic liver failure is also associated with some degree of brain edema. Astrocyte swelling is involved in such edema. Ammonia is regarded as a major factor responsible for astrocyte swelling in acute liver failure, while manganese takes an important role in astrocytc swelling in chronic liver failure, In both cases, however, the exact mechanisms that ammonia and manganese cause astrocyte swelling have not been completely understood. This article will discuss current views on some factors responsible for astrocyte swelling, mainly focusing on the potential role of oxidative stress and mitochondrial permeability transition. Key words: Hepatic encephalopathy ; Oxidative stress ; Mitochondrial permeability transition