Analysis of Response to Ursodeoxycholic Acid for Gallstone Dissolution

Bateson, M C; Hill, Andrew; Bouchier, I. A. D.

doi:10.1159/000198460

Cited by 21 publications

(6 citation statements)

References 11 publications

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“…Biliary lithocholic acid was partly present as sulfate ester. In the control period, 27 (1)(2)(3)(4)(5)(6)(7)(8)(9). In one study, the high dose resulted in more rapid gallstone dissolution (8).…”

Section: Biliary Cholesterol (mentioning

confidence: 99%

mentioning

confidence: 99%

“…Urso treatment leads to dissolution of cholesterol gallstones in man (1)(2)(3)(4)(5)(6)(7)(8)(9). Oral administration of Urso increases Urso in bile and decreases the biliary cholesterol (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). The increase in Urso conjugates in bile is accompanied by a decrease in other bile acids including cholic acid, chenodeoxycholic acid, deoxycholic acid and, in most studies, lithocholic acid (7,8,(11)(12)(13)(14)(15)17).…”

mentioning

confidence: 99%

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

Stiehl¹,

Raedsch²,

Rudolph³

et al. 1984

Hepatology

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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.

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Section: Biliary Cholesterol (mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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

Stiehl¹,

Raedsch²,

Rudolph³

et al. 1984

Hepatology

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“…In order to develop a better understanding of the interaction between bile acids and gallstone formation, individual bile acids from animals within each dietary group were analyzed. This was particularly important, because bile acids such as ursodeoxycholic, chenodeoxycholic and hyodeoxycholic acid have been shown to have the ability to dissolve gallstones when administered in the diet of humans (10)(11)(12)(13)(14)(15)(16)(17)(18). The present study seems to indicate that dietary proteins may have an effect on gallstone formation by altering concentrations of specific bile acids in hamsters.…”

Section: Effect Of Dietary Proteins On Biliary Lipids Studies In-mentioning

confidence: 66%

“…It is generally accepted that the abnormality which leads to formation of lithogenic bile involves an insufficient concentration of bile acid and/or phospholipid to prevent biliary cholesterol from precipitating out of solution. Several studies using human subjects (8)(9)(10)(11)(12)(13)(14)(15)(16)(17) have shown that the bile acid/phospholipid/cholesterol ratio can be altered by feeding chenodeoxycholic acid and thereby dissolving cholesterol gallstones. Ursodeoxycholic acid consumption has also been shown to be effective in dissolving cholesterol gallstones in humans (18) and hamsters (19).…”

mentioning

confidence: 99%

Dietary protein effects on cholelithiasis in hamsters: Interaction with amino acids and bile acids

Sullivan-Gorman

Anderson

DiMarco

et al. 1987

J Americ Oil Chem Soc

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The objective of this experiment was to study the effects of dietary cottonseed protein and casein on plasma and biliary lipids, plasma amino acids and gallstones in hamsters. Thirty‐four male hamsters (60 ± 5 g) were fed either the lithogenic “Dam Diet” (containing 20% casein, 74.3% sucrose and 5.7% vitamin‐mineral mix) or a similar diet that contained 20% cottonseed protein for 30 days. Both diets contained protein as a protein isolate. The concentration of alpha‐aminobutyric acid was significantly elevated in the casein‐fed group. Significant differences in the total plasma cholesterol or lipoprotein cholesterol concentrations were not observed between the two dietary groups. A significant elevation in the absolute concentration of biliary cholesterol was observed in the casein‐fed hamsters. Cottonseed protein‐fed animals exhibited a significantly elevated concentration of bile acids. The ratio of glycochenodeoxycholic:glycocholic acid was significantly higher in the cotton‐seed protein‐fed group. This study reports that an elevated concentration of biliary cholesterol with a concomitant decrease in bile acid concentration yields a condition favorable to gallstone formation. It is proposed that cottonseed protein may have a specific effect on the bile acid pool by increasing the ratio of glycochenodeoxycholic acid:glycocholic acid which, in turn, prevents formation of cholesterol gallstones.

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Ursodeoxycholic acid for the treatment of primary sclerosing cholangitis: A 30-month pilot study

et al. 1991

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We investigated the effects of once-daily oral administration of 10 mg/kg ursodeoxycholic acid (generic name, ursodiol) on elevated serum enzyme activities, bilirubin, cholesterol, bile acids and symptoms in patients with primary sclerosing cholangitis. A 30-mo, open-label, pilot trial was designed to cover four periods: (a) 3 mo of pretreatment observation (period 1), (b) 6 mo on ursodiol (period 2), (c) 3 mo withdrawal of treatment (period 3) and (d) 18 mo of extended retreatment (period 4). Diagnosis was confirmed by cholangiography and liver biopsy specimens. We enrolled 12 patients with persistently elevated pretreatment alkaline phosphatase and gamma-glutamyltransferase levels (at least twice the upper limit of normal), and observed them for a median of 37 mo. Significant reductions in serum total cholesterol levels and in serum enzyme activities indicating cholestasis and hepatocellular injury occurred during ursodiol treatment in both treatment periods 2 and 4 and relapsed with treatment interruption in period 3. Elevated serum bilirubin and symptoms of disabling fatigue, pruritus and diarrhea were improved by ursodiol. Improvements have continued after 2 yr of treatment in 10 patients (1 patient had a transplantation after he relapsed on withdrawal of ursodiol therapy; another died of postoperative complications of colon resection for carcinoma). No other cases of clinical deterioration were observed in the retreatment period. The longer term reductions of alkaline phosphatase, transaminases, bilirubin and cholesterol after 2 yr of treatment were even greater than the initial reductions after 6 mo of treatment. These results justify initiation of larger, controlled clinical trials, with serial morphological evaluations of the liver and biliary tree.

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Analysis of Response to Ursodeoxycholic Acid for Gallstone Dissolution

Cited by 21 publications

References 11 publications

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

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

Dietary protein effects on cholelithiasis in hamsters: Interaction with amino acids and bile acids

Ursodeoxycholic acid for the treatment of primary sclerosing cholangitis: A 30-month pilot study

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