Overview

We are conducting a phase 4 randomised, placebo-controlled drug trial of L-ornithine L-aspartate (LoLA) therapy. The protocol comprises a longitudinal 3-month investigation of brain and muscle function of 34 subjects with established cirrhosis and minimal hepatic encephalopathy (MHE) at three-time points (baseline, week 4 and week 12). We are investigating the hypothesis that LoLA is thought to improve brain function by increasing nitrogen elimination in the liver (thereby reducing hyperammonaemia in these patients) and reduce sarcopenia by promoting glutamine uptake peripherally.  The effects of this treatment on brain function are being investigated by advanced MRI.

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Key publications

• McPhail MJ, Leech R, Grover VP, Fitzpatrick JA, Dhanjal NS, Crossey MM, Pflugrad H, Saxby BK, Wesnes K, Dresner MA, Waldman AD, Thomas HC, Taylor-Robinson SD. Modulation of neural activation following treatment of hepatic encephalopathy. Neurology. 2013;80:1041-1047.
• McPhail MJ, Dhanjal NS, Grover VP, Taylor-Robinson SD.  Ammonia and cerebral water. Importance of structural analysis of the brain in hepatic encephalopathy. J Hepatol. 2012;56:506-507.
• McPhail MJ, Patel NR, Taylor-Robinson SD. Brain imaging and hepatic encephalopathy. Clin Liver Dis 2012;16:57-72
• McPhail MJW, Thomas HC, Taylor-Robinson SD. Magnetic Resonance Studies of the Brain in Liver Disease. In S. Keiding, M Sorensen (eds), Functional Molecular Imaging in Hepatology. Chapter 15. pp160-182. Bentham Books, Bussum, Netherlands (ISBN-13: 978-1-60805-290-5)
• McPhail MJ, Taylor-Robinson SD. The role of magnetic resonance imaging and spectroscopy in hepatic encephalopathy. Metab Brain Dis. 2010;25:65-72.

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Principal investigator

• Simon Taylor-Robinson

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Researchers involved

• Albert Busza
• James Cole
• Nicola Cook
• Mary Crossey
• Julie Fitzpatrick
• Nimzing Ladep
• Robert Leech
• Mark McPhail