Effect of Ursodeoxycholic Acid on Biliary Bile Acid and Bile Lipid Composition in Gallstone Patients

Abstract

In five patients with radiolucent gallstones, the effect of ursodeoxycholic acid (Urso) in doses of 250, 500, 750, 1,000, and 1,250 mg per day on biliary lipid and bile acid composition was studied. Biliary cholesterol decreased from 8.8 +/- 0.8 mole% to 4.4 +/- 0.2 mole% at 500 mg Urso per day (7.1 mg per kg) and to 4.2 +/- 0.3 mole% at 750 mg Urso per day (10.7 mg per kg). Administration of 1,000 or 1,250 mg Urso per day produced no further decrease of biliary cholesterol. The biliary content of phospholipids and total bile acids remained unchanged. During Urso treatment, the relative amounts of glyco-Urso and tauro-Urso in bile increased. Glyco-Urso reached a plateau at 49.1 +/- 2.1% of total bile acids during treatment with 1,000 mg Urso per day, and tauro-Urso increased up to 4.3 +/- 1.5% of total bile acids at 250 mg Urso per day. Simultaneously cholic acid, chenodeoxycholic acid, deoxycholic acid, and lithocholic acid decreased. The data indicate that Urso treatment reduces biliary cholesterol efficiently already at a dose of 500 mg per day; biliary bile acid composition changes up to 1,000 mg Urso per day. Doses greater than 1,000 mg per day produced no additional alterations in bile composition.

Intestinal absorption and biliary secretion of ursodeoxycholic acid and its taurine conjugate

“…Biliary enrichment with UDCA in our patients with biliary–duodenal drainage was similar to that in patients without drainage receiving UDCA [36–41], TUDCA [42], or taurine in addition to UDCA [43]. The slightly increased biliary secretion of lithocholic acid is most probably a result of its bacterial formation from ursodeoxycholic acid in the intestine [44,45].…”

Betel quid chewing leads to the development of unique de novo malignancies in liver transplant recipients, a retrospective single center study in Taiwan

“…OLT for end-stage liver disease was performed for the first time in 1983 [1] and graft rejection decreased dramatically after the introduction of immunosuppressive agents. [30] The 1- and 5-year acceptable survival rates after liver transplantation are 90% and 70%, respectively, worldwide.…”

“…Orthotopic liver transplantation (OLT) has had a great impact on patients with end-stage liver disease since the National Institutes of Health’ Consensus Development Conference in June 1983 [1] and it has also been the most effective treatment for patients with acute liver failure related to virus infection or other etiologies. [2] In patients with HCC, it is the treatment of choice with better disease-free survival compared to other treatments such as hepatectomy and radiofrequency ablation (RFA).…”

A randomized trial in primary biliary cirrhosis comparing ursodeoxycholic acid in daily doses of either 10 mg/kg or 20 mg/kg

“…For patients treated with UDCA, biliary enrichment is determined by the intestinal absorption of UDCA and the subsequent uptake and excretion by the liver. Previous studies of patients with 9 , 24 –27 and without liver disease 28 , 29 have shown that higher doses of UDCA lead to greater biliary enrichment, although the relative intestinal absorption of UDCA may decrease simultaneously 27 , . 30 Biliary enrichment with UDCA was found to be related to biochemical improvement in some 9 , 31 , 32 but not all studies 7 , .…”