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A 2019 systematic review of five placebo-controlled trials conducted by one group of investigators examined the effect of acetyl-L-carnitine (ALCAR) in 398 participants with cirrhosis and portal hypertension (high blood pressure in the portal vein) and presenting with either subclinical or overt hepatic encephalopathy

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B cells, which are derived from pluripotent stem cells in the bone marrow, differentiate into plasma cells upon antigen stimulation and are responsible for humoral immunity through the secretion of immunoglobulins such as IgG, IgA, and IgM