516 GLYCOGEN SYNTHASE KINASE 3 (GSK3) IN IMMUNE CELLS IS A MAJOR PLAYER INTLR4-MEDIATED CYTOKINE STORM IN PATIENTS WITH ADVANCED CIRRHOSIS

POSTERSplacebo and viceversa for another 4 weeks.For statistic analysis, we compared two arms and four period of treatment (A1, A2, B1, B2), A1 vs. B1 and A2 vs. B2.We analyzed liver function, under curve area (AUC) of glutamine oral challenge (OGC), MHE, critical flicker frequency (CFF) and measured fasting insulin and glucose levels to calculate HOMA = insulin (mIU/ml) * glucose (mmol/L)/22.5 before and after each treatment period.Results: Patients belonging to A1 showed a statistically significant improvement in the area under the curve (AUC) of glutamine oral challenge in comparison with B1 (-52.3±53mcg/ml/h vs -5.62±10.56mcg/ml/h, p = 0.045).This changes, but without significant statistical differences, were seen when compared B2 vs. A2 (74±45.6 mcg/ml/h vs. 13±37.19mcg/ml/h;p=NS).PHES score used in the diagnosis of MHE was significantly improved in A2 in comparison with B2 (2±1.75 vs. -1±1.15,p = 0.05).No significant changes were seen in liver function or insulin resistance. Conclusion:One arm of the study showed imporvement in intestinal ammonia production (AUC OGC) and psychometric tests (PHES) within the first four weeks of treatment, that was subsequently reproduced with less intensity in the second part of the study.The active arm seems to be superior to placebo arm and final results are warranted.