Marrone G, Serra A, Miele L, Biolato M, Liguori A, Grieco A, Gasbarrini A. Branched chain amino acids in hepatic encephalopathy and sarcopenia in liver cirrhosis: Evidence and uncertainties. World J Gastroenterol 2023; 29(19): 2905-2915 [PMID: 37274800 DOI: 10.3748/wjg.v29.i19.2905]
Corresponding Author of This Article
Giuseppe Marrone, MD, PhD, Consultant Physician-Scientist, Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo Agostino Gemelli 8, Rome 00168, Italy. giuseppe.marrone@policlinicogemelli.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 21, 2023; 29(19): 2905-2915 Published online May 21, 2023. doi: 10.3748/wjg.v29.i19.2905
Branched chain amino acids in hepatic encephalopathy and sarcopenia in liver cirrhosis: Evidence and uncertainties
Giuseppe Marrone, Amato Serra, Luca Miele, Marco Biolato, Antonio Liguori, Antonio Grieco, Antonio Gasbarrini
Giuseppe Marrone, Amato Serra, Luca Miele, Marco Biolato, Antonio Liguori, Antonio Grieco, Antonio Gasbarrini, Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
Author contributions: Marrone G and Serra A were responsible for the conception and writing of the paper; Miele L, Biolato M, and Liguori A reviewed the manuscript; Grieco A and Gasbarrini A performed final editing of the manuscript; and all the authors approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giuseppe Marrone, MD, PhD, Consultant Physician-Scientist, Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo Agostino Gemelli 8, Rome 00168, Italy. giuseppe.marrone@policlinicogemelli.it
Received: December 28, 2022 Peer-review started: December 28, 2022 First decision: January 10, 2023 Revised: January 24, 2023 Accepted: April 20, 2023 Article in press: April 20, 2023 Published online: May 21, 2023 Processing time: 138 Days and 10 Hours
Abstract
Liver cirrhosis is commonly associated with nutritional alterations, reported in 20% of patients with compensated disease and over 60% of patients with decompensated cirrhosis. Nutritional disturbances are associated with a worse prognosis and increased risk of complication. Serum levels of branched-chain amino acids (BCAAs) are decreased in patients with liver cirrhosis. The imbalance of amino acids levels has been suggested to be associated with the development of complications, such as hepatic encephalopathy and sarcopenia, and to affect the clinical presentation and prognosis of these patients. Several studies investigated the efficacy of BCAAs supplementation as a therapeutic option in liver cirrhosis, but uncertainties remain about the real efficacy, the best route of administration, and dosage.
Core Tip: Nutritional perturbance is frequent in liver cirrhosis and has been correlated with the development of complications such as hepatic encephalopathy and sarcopenia. Branched-chain amino acids (BCAAs) have been implicated in the pathophysiology of these two complications and supplementation has been proposed as a therapeutic measure. In this review, we will examine the scientific evidence supporting the clinical use of BCAAs in cirrhotic subjects.
