Role of Branched Chain Amino Acids supplementation on quality of life in liver cirrhosis patients

Due to nutrition distortions and energy metabolism, protein energy malnutrition (PEM) is triggered in liver cirrhosis (LC). Since PEM is directly related to the prognosis of LC, it has been postulated that supplementation of Branched Chain Amino Acids (BCAAs) which comprised of the amino acids valine, leucine and isoleucine is helpful in LC. Decreased BCAAs and increased Aromatic Amino Acids (AAAs) are typical abnormalities in the blood of individuals with liver cirrhosis, which play a function in the pathogenesis of hepatic encephalopathy and muscle loss. As the concentration of AAAs increased, it was hypothesized that the influx of AAAs into the brain increased, resulting in an imbalance of the neurotransmitter synthesis, particularly serotonin and noradrenaline. It may cause an aggregation of ‘false’ neurotransmitters such as octopamine, which may in effect be responsible for Hepatic Encephalopathy associative cognitive impairment. HE is a reversible disordered brain function condition that arises in people with progressive liver failure. BCAAs treatment significantly raises the BCAAs/AAAs ratio and reduces the grade of hepatic encephalopathy. Since the nutritional treatment focused on the administration of BCAAs, it resulted in an improvement in the clinical condition, which also led to an improvement in quality of live (QOL).