Gutiérrez VI, Domínguez MA

Idioma: Español
Referencias bibliográficas: 39
Paginas: 60-70
Archivo PDF: 120.23 Kb.

RESUMEN

La encefalopatía hepática es un trastorno neuropsiquiátrico que ocurre en la insuficiencia hepática aguda o crónica. Estos cambios se han atribuido a los efectos tóxicos del amonio y/o del manganeso, que en la insuficiencia hepática se acumulan en el cerebro. Parece estar involucrada una disminución en la neurotransmisión más que una deficiencia primaria en el metabolismo energético cerebral. Los sistemas de neurotransmisores implicados en la patogénesis de la encefalopatía hepática incluyen las sinapsis glutamatérgicas, gabaérgicas, serotoninérgicas, así como catecolaminérgicas y el sistema opioide. La célula neural más vulnerable en la insuficiencia hepática es el astrocito. El astrocito sufre cambios conocidos como astrocitosis Alzheimer tipo II. Se requieren más estudios que permitan dilucidar la naturaleza precisa de estas alteraciones, lo que resultará en el diseño de nuevas estrategias farmacoterapéuticas para la prevención y tratamiento de la encefalopatía hepática.

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