The Role of Neuroinflammation in the Pathogenesis of Hepatic Encephalopathy

Liver disease impacts millions of Americans every year, which is compounded by the comorbidities and consequences that patients are susceptible to developing. Hepatic encephalopathy (HE) is a severe consequence of liver failure resulting in a range of cognitive deficits that heavily impact quality of life. Approximately 40% of acute liver failure (ALF) patients and 50% of chronic liver disease patients will be diagnosed with HE, and the associated prognosis is 44% and 42%, respectively. Though understanding of some of the neurologic impacts of liver impairment exists, the pathology of HE is not yet fully elucidated. Many in the field have come to appreciate the role of neuroinflammation in its pathogenesis. In this review, we have summarized recent studies investigating aspects of neuroinflammation such as microgliosis, astrogliosis, proinflammatory cytokine and chemokine production, and the involvement of the choroid plexus and meninges in HE.