ABSTRACT
To address the role of the opioid system in the pathogenesis of hepatic encephalopathy [HE] we measured plasma met- enkephalin, beta -endorphin and leu- enkephalin in patients with different grades of HE compared to control subjects and patients with cirrhosis. Plasma met- enkephalin levels were significantly higher in patients with cirrhosis and all grades of HE than controls. Plasma beta levels were similar in the 3 groups. Plasma leu- enkephalin levels were significantly higher -endorphin in HE grades II, III and IV than in controls, patients with cirrhosis and HE grade I patients. Our results support data on the involvement of met- enkephalin and leu- enkephalin in the pathogenesis of HE and provide a rationale for the use of opioid receptor antagonists in the treatment of HE