Question

Protein-Energy malnutrition (PEM) is a common manifestation in cirrhotic patients with a reported incidence of 65 – 90%. One treatment technique is to add branched chain amino acids and/or their keto analogs to the diet. Why do you think clinicians use this as a potential treatment?

Answer 1

The major important problems of liver cirrhosis is nutritional problems. Not only the liver cirrhosis but also the liver cancer, liver injury etc. Hypoalbuminemia, ascitis and edema are the most common symptoms of liver disease. The branches chain amino acids like valine, leucine and isoleucine are three amino acids help to improve liver function in liver disease. Most of the studies show that administration of oral branched chain amino acid help to improve prognosis of liver disease patients.

Mechanisms of action of branched chain amino acids included

:induce mitochondrial biogenesis and therefore inhibit the production of ROS factor.

:delay progression of ccl4 - induced chronic liver injury by reducing apoptosis of RAP

:encourage synthesis of albumin and glycogen ___the BCAAs are help to activate m. TOR and increase production of eukaryotic initiation factor GE-binding protein, ribosomal protein s6 kinase this will improve albumin synthesis and glycogen synthesis

:it help in insulin resistance

:improving immunity

:suppress the proliferation of liver cancer cell and improve regeneration of liver cells.

So, the administration of BCAAs improve over all health status of liver disease patients and it improves nutrional status. So the clinician choose BCAAs as management for liver disease to improve prognosis.