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Damião, Adérson Omar Mourão Cintra; Sipahi, Aytan Miranda; Vezozzo, Denise P.; Gonçalves, Patrícia Lofêgo; Habr‐Gama, Angelita; Teixeira, Magaly G.; Fukushima, Júlia Tizue; Laudanna, Antônio Atílio

doi:10.1023/a:1018841213480

Cited by 14 publications

(3 citation statements)

References 40 publications

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“…In a previous study, obacunone attenuated ulcerative colitis symptoms in mice by modulating the gut microbiota, disrupting the TLR4/NF-κB signaling cascades, and restoring intestinal epithelial barrier integrity ( Luo et al, 2020 ). Ulcerative colitis increases CGS prevalence by influencing bile acids and gall bladder emptying ( Mark-Christensen et al, 2017 ; Malik and Aurelio, 2023 ), where bile stasis leads to bile dehydration, increasing cholesterol concentration ( Damião et al, 1997 ), and stone precipitation. Furthermore, obacunone prevents obesity and hyperglycemia, two independent risk factors for CGS ( Lammert et al, 2016 ), by activating TGR5 and inhibiting PPARγ transcriptional activity ( Horiba et al, 2015 ), which are related to bile metabolism ( Chávez-Talavera et al, 2017 ; Jia et al, 2018 ; Sorrentino et al, 2020 ; Castellanos-Jankiewicz et al, 2021 ) and CGS formation ( Dong et al, 2011 ; Wang et al, 2018 ; Han et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Chaihu Shugan prevents cholesterol gallstone formation by ameliorating the microbiota dysbiosis and metabolic disturbance in mice

Wang,

Zhang,

Liu

et al. 2024

Front. Pharmacol.

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Introduction: Cholesterol gallstone (CGS) is a biliary tract disorder requiring treatment in approximately 20% of patients. The efficacy of Chaihu Shugan in preventing CGS recurrence after successful treatment remains uncertain.Methods: We examined the in vivo preventive efficacy of Chaihu Shugan using a CGS mouse model and used multi-omics to study the interplay between gut microbiota, metabolism, and gene expression.Results: The intestinal microbiota was severely dysregulated during the formation of CGS, showing a marked decrease in the abundance of beneficial microbiota, especially Lactobacillus and Akkermansia. Chaihu Shugan prevented CGS formation by restoring the composition of the gut microbiota and reversing the metabolic disturbances caused by dysbiosis. This preventive effect of Chaihu Shugan was paralleled by changes in the expression of metabolism-related genes in the liver. A network pharmacology analysis of Chaihu Shugan revealed that obacunone may be the key active metabolite in regulating bile acid metabolism. Multi-omics and correlation analyses elucidated the interplay between gut microbiota, metabolism, and gene alterations in the dose-dependent effect of Chaihu Shugan.Conclusion: Our data show that Chaihu Shugan can prevent CGS and indicate its mechanisms of action.

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Section: Discussionmentioning

confidence: 99%

Chaihu Shugan prevents cholesterol gallstone formation by ameliorating the microbiota dysbiosis and metabolic disturbance in mice

Wang,

Zhang,

Liu

et al. 2024

Front. Pharmacol.

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“…In patients with LRP, resection of a short segment of the ileum and the entire colon inhibits bile acid absorption, resulting in supersaturation of biliary cholesterol[ 8 ], pouch metaplasia with decreased primary bile acid absorption[ 33 ], and delayed gall bladder emptying[ 34 ]. We found a high incidence of recurrent biliary colic requiring surgery (12/17, 70.5%), while the remaining five cases had a stationary course without symptoms.…”

Section: Discussionmentioning

confidence: 99%

Hepatobiliary manifestations following two-stages elective laparoscopic restorative proctocolectomy for patients with ulcerative colitis: A prospective observational study

Habeeb¹,

Hussain²,

Podda³

et al. 2023

World J Gastrointest Surg

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BACKGROUND Hepatobiliary manifestations occur in ulcerative colitis (UC) patients. The effect of laparoscopic restorative proctocolectomy (LRP) with ileal pouch anal anastomosis (IPAA) on hepatobiliary manifestations is debated. AIM To evaluate hepatobiliary changes after two-stages elective laparoscopic restorative proctocolectomy for patients with UC. METHODS Between June 2013 and June 2018, 167 patients with hepatobiliary symptoms underwent two-stage elective LRP for UC in a prospective observational study. Patients with UC and having at least one hepatobiliary manifestation who underwent LRP with IPAA were included in the study. The patients were followed up for four years to assess the outcomes of hepatobiliary manifestations. RESULTS The patients' mean age was 36 ± 8 years, and males predominated (67.1%). The most common hepatobiliary diagnostic method was liver biopsy (85.6%), followed by Magnetic resonance cholangiopancreatography (63.5%), Antineutrophil cytoplasmic antibodies (62.5%), abdominal ultrasonography (35.9%), and Endoscopic retrograde cholangiopancreatography (6%). The most common hepatobiliary symptom was Primary sclerosing cholangitis (PSC) (62.3%), followed by fatty liver (16.8%) and gallbladder stone (10.2%). 66.4% of patients showed a stable course after surgery. Progressive or regressive courses occurred in 16.8% of each. Mortality was 6%, and recurrence or progression of symptoms required surgery for 15%. Most PSC patients (87.5%) had a stable course, and only 12.5% became worse. Two-thirds (64.3%) of fatty liver patients showed a regressive course, while one-third (35.7%) showed a stable course. Survival rates were 98.8%, 97%, 95.8%, and 94% at 12 mo, 24 mo, 36 mo, and at the end of the follow-up. CONCLUSION In patients with UC who had LRP, there is a positive impact on hepatobiliary disease. It caused an improvement in PSC and fatty liver disease. The most prevalent unchanged course was PSC, while the most common improvement was fatty liver disease.

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“…Diminished gallbladder emptying was found in patients with ulcerative colitis after colectomy [26]; however, the pathophysiological mechanisms remain unclear. Impaired gallbladder motility is regarded as a risk factor for the development of gallstones [27].…”

Section: Discussionmentioning

confidence: 99%

Kinetics of Primary Bile Acids in Patients after Proctocolectomy and Ileal Pouch-Anal Anastomosis

Gotthardt

Sauer²,

Schaible³

et al. 2014

Digestion

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Background: The high incidence of cholesterol gallstones in patients after proctocolectomy with ileal pouch-anal anastomosis (IPAA) may be due to an increased loss of bile acids. We aimed to evaluate the kinetics of the primary bile acids cholic acid (CA) and chenodeoxycholic acid (CDCA) in these patients. Methods: Pool sizes, synthesis rates, and fractional turnover rates of CA and CDCA were determined by combined capillary gas chromatography/isotope ratio mass spectrometry in serum samples after administration of [¹³C]CA and [¹³C]CDCA in 6 patients and 9 healthy volunteers. Results: In patients with IPAA, pool sizes of CA and CDCA were 11.5 (8.2-23.8) and 12.1 (6.7-20.1) µmol/kg, respectively, and were significantly lower than in healthy controls [36.0 (24-47) and 29.0 (21-42) µmol/kg, respectively; p < 0.05, each]. Fractional turnover rates of CA [1.19 (1.06-1.82) vs. 0.31 (0.13-0.54) per day] and CDCA [1.01 (0.50-1.63) vs. 0.23 (0.09-0.36) per day] were increased fourfold in patients with IPAA (p < 0.05, each). Synthesis rates of CDCA [10.2 (5.2-32.9) vs. 6.6 (2.7-10.5) µmol/kg per day, p = 0.05] and CA [15.1 (9.3-39.4) vs. 11.5 (3.1-20.5) µmol/kg per day, n.s.] tended to be higher in patients with IPAA than in controls. Conclusion: The reduced pool size of primary bile acids may contribute to the high incidence of cholesterol gallstones in patients after proctocolectomy and IPAA.

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Untitled

Cited by 14 publications

References 40 publications

Chaihu Shugan prevents cholesterol gallstone formation by ameliorating the microbiota dysbiosis and metabolic disturbance in mice

Chaihu Shugan prevents cholesterol gallstone formation by ameliorating the microbiota dysbiosis and metabolic disturbance in mice

Hepatobiliary manifestations following two-stages elective laparoscopic restorative proctocolectomy for patients with ulcerative colitis: A prospective observational study

Kinetics of Primary Bile Acids in Patients after Proctocolectomy and Ileal Pouch-Anal Anastomosis

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