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A meta-analysis of 6 RCTs with a total of 641 patients found that flumazenil (benzodiazepine receptor antagonist) treatment versus placebo resulted in significant clinical improvement of HE (odds ratio = 6.15

The polyubiquitin chain, which is essential for degradation of most substrates by the 26S proteasome, is formed through isopeptide bonds between the carboxyl terminus of Gly76 of one ubiquitin and the amino group of the lysine residues at positions 48 (K48) of another ubiquitin molecule (Chau et al., 2007) and mice (Irmler et al., 2002

References Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes