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CNS & Neurological Disorders - Drug Targets

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ISSN (Print): 1871-5273
ISSN (Online): 1996-3181

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Non-hepatic Hyperammonemia: A Potential Therapeutic Target for Sepsis-associated Encephalopathy

Author(s): Lina Zhao, Yun Li, Yunying Wang, Zengzheng Ge, Huadong Zhu, Xiuhua Zhou and Yi Li*

Volume 21, Issue 9, 2022

Published on: 18 April, 2022

Page: [738 - 751] Pages: 14

DOI: 10.2174/1871527321666211221161534

Price: $65

Abstract

Sepsis-Associated Encephalopathy (SAE) is a common complication in the acute phase of sepsis, and patients who develop SAE have a higher mortality rate, longer hospital stay, and worse quality of life than other sepsis patients. Although the incidence of SAE is as high as 70% in sepsis patients, no effective treatment is available for this condition. To develop an effective treatment for SAE, it is vital to explore its pathogenesis. It is known that hyperammonemia is a possible factor in the pathogenesis of hepatic encephalopathy as ammonia is a potent neurotoxin. Furthermore, our previous studies indicate that non-hepatic hyperammonemia seems to occur more often in sepsis patients; it was also found that >50% of sepsis patients with non-hepatic hyperammonemia exhibited encephalopathy and delirium. Substatistical analyses indicate that non-hepatic hyperammonemia is an independent risk factor for SAE. This study updates the definition, clinical manifestations, and diagnosis of SAE; it also investigates the possible treatment options available for non-hepatic hyperammonemia in patients with sepsis and the mechanisms by which non-hepatic hyperammonemia causes encephalopathy.

Keywords: Sepsis, sepsis-associated encephalopathy, non-hepatic hyperammonemia, pathogenesis, serum ammonia, delirium.

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