Mechanisms of ammonia-induced astrocyte swelling

M. D. Norenberg, K. V. Rama Rao, A. R. Jayakumar

Research output: Contribution to journalArticlepeer-review

150 Scopus citations


Astrocyte swelling represents the major factor responsible for the brain edema associated with fulminant hepatic failure (FHF). The edema may be of such magnitude as to increase intracranial pressure leading to brain herniation and death. Of the various agents implicated in the generation of astrocyte swelling, ammonia has had the greatest amount of experimental support. This article reviews mechanisms of ammonia neurotoxicity that contribute to astrocyte swelling. These include oxidative stress and the mitochondrial permeability transition (MPT). The involvement of glutamine in the production of cell swelling will be highlighted. Evidence will be provided that glutamine induces oxidative stress as well as the MPT, and that these events are critical in the development of astrocyte swelling in hyperammonemia.

Original languageEnglish (US)
Pages (from-to)303-318
Number of pages16
JournalMetabolic Brain Disease
Issue number4
StatePublished - Dec 2005
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Clinical Neurology
  • Cellular and Molecular Neuroscience


  • Ammonia
  • Aquaporin-4
  • Cell swelling
  • Glutamine
  • Glutathione
  • Lactate
  • Mitochondrial permeability transition
  • Neurosteroids
  • Oxidative stress
  • Peripheral benzodiazepine receptor


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