Favorable and harmful effects of branched-chain amino acid administration in patients with liver cirrhosis: effects on hepatic encephalopathy and ammonia metabolism

Liver cirrhosis is associated with impaired liver function due to various metabolic disorders, causing poor prognosis and several complications, such as hepatic encephalopathy. Although a number of studies have re-ported the favorable effects of branched-chain amino acid (BCAA) administration on hepatic encephalopathy, liver function, and prognosis, several studies have shown that BCAA administration might be associated with the following adverse effects: activated glutamine catabolism to ammonia and drainage of alpha-ketoglutarate from the TCA cycle. This review presents the mechanism and management of the favorable and harmful effects of BCAA administration in patients with liver cirrhosis.