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1. Introduction
2. Classification of hepatic encephalopathy (HE)
3. Acute liver failure (ALF)
4. Neuropathology of ALF (1)
5. Neuropathology of ALF (2)
6. Microglial activation and neuroinflammation in ALF
7. BBB breakdown in ALF- if infection\sepsis present
8. Pathogenesis of HE in ALF - key role of ammonia
9. Ammonia produced in the gut, removed by the liver
10. Arterial ammonia predicts brain herniation in ALF
11. Arterial NH3: risk factor of intracranial hypertension
12. NH3 removal by brain: a neuroglial responsibility
13. Ammonia removal by brain
14. Selective gene expression alterations in ALF
15. Glial fibrillary acidic protein (GFAP)
16. Loss of GFAP mRNA in brain in ALF
17. GFAP levels & brain edema - negative correlation
18. Glutamate transporter EAAT-2
19. Glutamate transporters in forebrain
20. Decreased EAAT-2 mRNA/protein in brain in ALF
21. Consequence of loss of EAAT-2 expression
22. Extracellular brain glutamate & neurological status
23. Systemic inflammation in ALF
24. Neuroinflammation in ALF
25. Microglial activation and neuroinflammation in ALF
26. Brain cytokines in ALF
27. Brain cytokine gene expression in ALF: in rat
28. Brain cytokine gene expression in ALF: in mouse
29. Therapeutic implications
30. Do treatments act on neuroglial mechanisms?
31. Mild hypothermia limits microglial activation (ALF)
32. Mild hypothermia reduces brain cytokines (ALF)
33. Mild hypothermia reduces brain cytokine levels
34. NAC prevents neuroinflammation in ALF
35. Minocycline
36. Brain edema in ALF (minocyclin-protective effect)
37. Minocyclin and brain pro-inflammatory cytokines
38. Minocyclin and brain cytokine gene expression
39. Take home messages (1)
40. Take home messages (2)
41. Acknowledgements

Topics Covered

• Classification of hepatic encephalopathy
• Acute liver failure
• Neuropathology of Acute liver failure
• Pathogenesis of hepatic encephalopathy in Acute liver failure: key role of ammonia
• Arterial NH3: risk factor of intracranial hypertension
• Selective gene expression alterations in Acute liver failure
• Glial fibrillary acidic protein (GFAP)
• Glutamate transporter EAAT-2
• Extracellular brain glutamate and neurological status
• Systemic inflammation in Acute liver failure
• Brain cytokines in Acute liver failure
• Therapeutic implications

Links

Series:

• Physiology and Pathophysiology of Neuroglia

Categories:

• Clinical Practice
• Neuroscience

Therapeutic Areas:

• Neurology

Talk Citation

Butterworth, R.F. (2013, November 28). Hepatic encephalopathy in acute liver failure: a primary neurogliopathy [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved April 15, 2025, from https://doi.org/10.69645/FJTR6685.
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Publication History

• Published on November 28, 2013

Financial Disclosures

• Prof. Roger F. Butterworth, Speaker’s Bureau: Merz Pharmaceuticals, Frankfurt, Germany.