"Endogenous" benzodiazepine activity in body fluids of patients with hepatic encephalopathy

Kevin D. Mullen, Karen M. Szauter, Kristine Kaminsky-Russ

Research output: Contribution to journalArticlepeer-review

122 Scopus citations


Body fluids from patients with hepatic encephalopathy and from controls with no renal or hepatic disease were assayed for benzodiazepine immunoreactivity and benzodiazepine-receptor-binding activity. The subjects had taken no synthetic benzodiazepines for at least 3 months. Benzodiazepine receptor binding in cerebrospinal fluid was significantly higher in hepatic encephalopathy patients than in controls (210 [SE 50·2] vs 40·7 [7·3] oxazepam equivalents [ng/ml]). The severity of hepatic encephalopathy was directly and significantly correlated with the level of benzodiazepine activity by radioreceptor assay or radioimmunoassay in urine and in plasma. Benzodiazepine activity equivalent to levels of more than 900 ng/ml was found in patients with advanced encephalopathy. Although the chemical identity and source of this substance (or substances) are still unknown, its properties and the estimated levels of activity suggest it may have a role in the pathogenesis of the neural inhibition seen in hepatic encephalopathy.

Original languageEnglish (US)
Pages (from-to)81-83
Number of pages3
JournalThe Lancet
Issue number8707
StatePublished - Jul 14 1990
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine


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