Metabolomics in the understanding and management of hepatic encephalopathy

Metabolomics refers to the study of biological components below 1000 Daltons (Da) involved in metabolic pathways as substrates, products or effectors. According to the interconnected metabolic disturbances that have been described in the pathophysiology of hepatic encephalopathy (HE), this technique appears to be well adapted to study and better delineate the disease. This review will focus on recent advances in metabolomics in the field of HE. Thus, after a brief overview of the general principles of metabolomics, we will discuss metabolomics as a potentially efficient tool for unraveling new HE pathophysiological insights, biomarkers identification, or as a predicting tool for treatment response or outcome prognosis. Finally, we will give our vision on the prospects offered by metabolomics for improving care of HE patients. [Display omitted] •Metabolomics refers to the study of biological components below 1000 Daltons (Da).•Untargeted metabolomics provide potential associations of metabolites to metabolic pathways which can be further associated to a biochemical phenotype.•According to the pathophysiology of HE made from a close interaction between systemic inflammation and metabolic disturbances metabolomics appears as a promising technique.•Recent studies suggest that metabolomics could unravel new HE pathophysiological pathways, enable the identification of new biomarkers and help in the prognostication.•Some portable devices are in development and could lead to bring metabolomics to the bedside of HE patients.