Darakhshan M Saleem, Saida Haider, Moona M Khan, Tahir Shamsi, Darakhshan J Haleem.
Role of tryptophan in the pathogenesis of hepatic encephalopathy.
J Pak Med Assoc Jan ;58(2):68-70.

Objective: To monitor serum levels of total and free tyryptophan in various hepatic dysregulations. Method: The study was conducted on 36 adult patients. All were suffering from acute or chronic liver diseases such as hepatitis (n= 12), cirrhosis (n= 12) and Hepatic Encephalopathy (HE) (n=12). Patients of all age groups and both genders were included. Serum levels of Tyryptophan (TRP) were measured by HPLC-EC. Albumin and bilirubin were analyzed by kit method (Merck). Results: The serum levels of total TRP (p<0.01) was found in all patients. Free TRP significantly (p<0.01) increased only in HE. Patients with hepatitis and cirrhosis did not show significant change in serum free TRP. The Albumin levels significantly decreased in hepatitis, cirrhosis and in HE (p<0.01). All patients exhibited hypoalbuminaemia (p<0.01). Conclusions: The results suggest that an increased ratio of free to bound TRP enhances its availability to the brain, which in turn increases 5-HT synthesis thus precipitating encephalopathy (JPMA 58:68;2008).

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