Table 1.

Adverse effects of individual treatment options of HE targeting GLN metabolism

Treatment	Adverse effects	Comment
GLN restriction	↓ GLN ?	Applicable only in artificial diet formulas.
Glutamate	↑ GLN	Favorable effect only temporary.
α-KG	↓ BCAA?	BCAA levels should be monitored.
BCAA	↑ GLN	More effective in patients with BCAA deficiency?
Phenylbutyrate	↓ BCAA and GLN	BCAA and GLN levels should be monitored.
GA inhibitors	Impaired GLN catabolism by enterocytes and immune cells.	Adverse effect on intestine and immune system?