Abstract Purpose of review Branched-chain amino acids (BCAAs) have a peculiar role in whole-body nitrogen metabolism. BCAAs are a substrate for protein synthesis, and have been used to conserve or restore muscle mass in advanced liver disease. In addition, the competitive action of BCAAs on amino acid transport across the blood-brain barrier may improve hepatic encephalopathy. Recent findings The effects of BCAAs on nutrition and ultimately on prognosis of patients with advanced cirrhosis have been confirmed in a large multicenter, long-term trial. Similarly, BCAA treatment improved the prognosis of patients with hepatocellular carcinoma, treated by chemoembolization. The mechanism for the beneficial effects of BCAA is likely to depend on the stimulating activity of BCAA on hepatocyte growth factor, favoring liver regeneration. Summary After an experience of 25 years with BCAAs, new data supports their beneficial effect in liver diseases. Although the number of patients who cannot tolerate dietary proteins in amounts sufficient to meet their increased catabolism is probably low, in this specific setting BCAAs remains the sole treatment of proved efficacy.
Update on branched-chain amino acid supplementation in liver diseases / G Bianchi; R Marzocchi; F Agostini; G Marchesini Reggiani. - In: CURRENT OPINION IN GASTROENTEROLOGY. - ISSN 0267-1379. - STAMPA. - 21:(2005), pp. 197-200.
Update on branched-chain amino acid supplementation in liver diseases
BIANCHI, GIAMPAOLO;MARZOCCHI, REBECCA;MARCHESINI REGGIANI, GIULIO
2005
Abstract
Abstract Purpose of review Branched-chain amino acids (BCAAs) have a peculiar role in whole-body nitrogen metabolism. BCAAs are a substrate for protein synthesis, and have been used to conserve or restore muscle mass in advanced liver disease. In addition, the competitive action of BCAAs on amino acid transport across the blood-brain barrier may improve hepatic encephalopathy. Recent findings The effects of BCAAs on nutrition and ultimately on prognosis of patients with advanced cirrhosis have been confirmed in a large multicenter, long-term trial. Similarly, BCAA treatment improved the prognosis of patients with hepatocellular carcinoma, treated by chemoembolization. The mechanism for the beneficial effects of BCAA is likely to depend on the stimulating activity of BCAA on hepatocyte growth factor, favoring liver regeneration. Summary After an experience of 25 years with BCAAs, new data supports their beneficial effect in liver diseases. Although the number of patients who cannot tolerate dietary proteins in amounts sufficient to meet their increased catabolism is probably low, in this specific setting BCAAs remains the sole treatment of proved efficacy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
