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The administration of that ester in animal models reduced NH3 toxicity through the activation of urea cycle enzymes, the interaction with glutamate receptors, and the reduction of free radicals.5254 Studies have evaluated the use of ALC in patients with cirrhosis and occult and/or overt HE, showing that ALC produced improvement in quality of life, anxiety, depression, and cognitive functions.5558 Those studies demonstrated that the administration of ALC reduced NH3 levels and had a protective effect against ammonia toxicity and glutamate neurotoxicity