{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T02:14:31Z","timestamp":1774923271972,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,11,13]],"date-time":"2018-11-13T00:00:00Z","timestamp":1542067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008430","name":"Fundaci\u00f3n para el Fomento en Asturias de la Investigaci\u00f3n Cient\u00edfica Aplicada y la Tecnolog\u00eda","doi-asserted-by":"publisher","award":["GRUPIN14\u2010088"],"award-info":[{"award-number":["GRUPIN14\u2010088"]}],"id":[{"id":"10.13039\/501100008430","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["PSI2013\u201045924\u2010P"],"award-info":[{"award-number":["PSI2013\u201045924\u2010P"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["PSI2015\u201073111\u2010EXP"],"award-info":[{"award-number":["PSI2015\u201073111\u2010EXP"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["PSI2017\u201083893\u2010R"],"award-info":[{"award-number":["PSI2017\u201083893\u2010R"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["PSI2017\u201083893\u2010R"],"award-info":[{"award-number":["PSI2017\u201083893\u2010R"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","award":["PSI2015\u201073111\u2010EXP"],"award-info":[{"award-number":["PSI2015\u201073111\u2010EXP"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","award":["PSI2017\u201090806\u2010REDT"],"award-info":[{"award-number":["PSI2017\u201090806\u2010REDT"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hepatic encephalopathy is a severe complication of both chronic and acute liver diseases. The term hepatic encephalopathy stems from the belief that hepatic insufficiency is its fundamental etiopathogenic factor. However, most clinical cases show liver failure along with mesenteric venous portal hypertension. This portal hypertension would explain the abnormal mechanical forces suffered by the digestive tract in the early stages of the disorder. These forces could regulate some gut biochemical pathological pathways in a process known as mechanotransduction. Thus, portal hypertension would begin with the establishment of a mechanotransduced afferent or sensory inflammatory gut\u2010brain pathway, resulting in functional and structural changes in the central nervous system. In this review, we will revisit the term \u201chepatic encephalopathy\u201d in light of new results where portal hypertension occurs before liver failure and is accompanied by brain changes. Moreover, we will point out cellular links that can explain the microbiota, immune, gut, and brain axis disturbances found in this disorder.<\/jats:p>","DOI":"10.1111\/jgh.14514","type":"journal-article","created":{"date-parts":[[2018,10,22]],"date-time":"2018-10-22T05:19:50Z","timestamp":1540185590000},"page":"490-494","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Hepatic encephalopathy: Sometimes more portal than hepatic"],"prefix":"10.1111","volume":"34","author":[{"given":"Maria\u2010Angeles","family":"Aller","sequence":"first","affiliation":[{"name":"Department of Surgery, School of Medicine Complutense University of Madrid  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Arias","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience King's College London  London UK"},{"name":"INEUROPA (Instituto de Neurociencias del Principado de Asturias)  Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Blanco\u2010Rivero","sequence":"additional","affiliation":[{"name":"Department of Physiology, School of Medicine, Instituto de Investigaci\u00f3n Sanitaria del Hospital Universitario La Paz (Idi PAZ) Autonoma University of Madrid  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge L","family":"Arias","sequence":"additional","affiliation":[{"name":"INEUROPA (Instituto de Neurociencias del Principado de Asturias)  Oviedo Spain"},{"name":"Laboratory of Neuroscience, Department of Psychology University of Oviedo  Asturias Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime","family":"Arias","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine Complutense University of Madrid  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,11,13]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1600561"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.31250"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.11.015"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-007-9895-0"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03394.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04590.x"},{"key":"e_1_2_5_8_1","article-title":"Hepatic encephalopathy: a critical current review","author":"Hadjihambi A","year":"2017","journal-title":"Hepatol. Int."},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2015.03.003"},{"key":"e_1_2_5_10_1","first-page":"142","article-title":"Hepatic encephalopathy: an update on the pathophysiology and therapeutic options","volume":"5","author":"Elwir S","year":"2017","journal-title":"J. Clin. Transl. Hepatol."},{"key":"e_1_2_5_11_1","article-title":"The portal hypertension syndrome: etiology, classification, relevance, and animal models","author":"Bosch J","year":"2017","journal-title":"Hepatol. Int."},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201407-320MG"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(00)80422-5"},{"key":"e_1_2_5_14_1","first-page":"151","volume-title":"Diseases of the Liver and Biliary System","author":"Sherlock S","year":"1989"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2005.06.004"},{"key":"e_1_2_5_16_1","first-page":"G371","article-title":"Measurement of portal\u2010systemic shunting in the rat by using gamma\u2010labeled microspheres","volume":"240","author":"Chojkier M","year":"1981","journal-title":"Am. J. Physiol."},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00145.2002"},{"key":"e_1_2_5_18_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.2174\/978160805068010901010117","volume-title":"Microsurgery in Liver Research","author":"Aller MA","year":"2009"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000050094"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2017.07.007"},{"key":"e_1_2_5_21_1","first-page":"249","article-title":"Gut microbiome\u2010based therapeutics in liver cirrhosis: basic consideration for the next step","volume":"5","author":"Fukui H","year":"2017","journal-title":"J. Clin. Transl. Hepatol."},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v8.i36.1602"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-006-0063-1"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/108.6.652"},{"key":"e_1_2_5_25_1","first-page":"127","article-title":"Portal hypertensive enteropathy","volume":"27","author":"Mekaroonkamol P","year":"2015","journal-title":"World J. Hepatol."},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2015.06.019"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2017.02.022"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-011-1625-y"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2016.10.002"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2014.12.003"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.immunol.21.120601.141025"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2005.03831.x"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2011.03.019"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5876-5-44"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073858416687249"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.meg.0000243873.94572.de"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0100-879X2005000100019"},{"key":"e_1_2_5_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbr.2007.10.019"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.06.013"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/545018"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.05.054"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjgh.14514","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.14514","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T17:12:43Z","timestamp":1694711563000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.14514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,13]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1111\/jgh.14514"],"URL":"https:\/\/doi.org\/10.1111\/jgh.14514","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,13]]},"assertion":[{"value":"2018-06-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}