Role of a False Neurotransmitter, Octopamine, in the Pathogenesis of Hepatic and Renal Encephalopathy

Abstract

Lam, Kui Chun, Tall, A. R., Goldstein, G. B. & Mistilis, S. P. Role of a false neurotransmitter, octopamine, in the pathogenesis of hepatic and renal encephalopathy. Scand. J. Gastroent. 1973, 8, 465-472.

The role of false neurotransmitters in the pathogenesis of hepatic encephal-opathy was investigated by assay of octopamine in serum and urine. Serum levels and urinary excretion of octopamine were elevated in all of 25 patients with hepatic encephalopathy. There was a statistically significant correlation between the degree of encephalopathy and serum and urine octopamine values, and in 10 patients with hepatic encephalopathy studied on 2 or more occasions, octopamine levels paralleled variations in mental state. In patients with primary renal disease and no liver disease, renal failure per se caused elevations of urine and serum octopamine. In patients with liver disease with secondary impairment of renal function, rising serum octopamine levels cor-related significantly with decreasing glomerular filtration rate and maximal urine flow rate. Elevated levels of false neurotransmitters such as octopamine seem to be an important factor in the pathogenesis of hepatic encephalopathy, but their role in renal impairment secondary to liver disease remains undetermined.

Key-words::

• False neurotransmitters
• hepatic coma
• octopamine
• renal failure