Enterohepatic circulation of bile acids and its role in pathologies of the hepatobiliary system

Abstract

Enterohepatic circulation of bile acids is a highly regulated process of secretion of these compounds, intestinal reabsorption and reverse transport to the liver. Violation of this process has significant consequences for the homeostasis of the gastrointestinal tract, liver and the whole organism. This process is tightly controlled by regulatory enzymatic reactions with negative feedback, which leads to the maintenance of a pool and adequate homeostasis of bile acids. The main purpose of this article is to consider the mechanism of enterohepatic circulation of bile acids and evaluate their role both in the formation of pathologies of the hepatobiliary system of various origins, and as a predictor of such processes. We searched for original studies in the scientific databases PubMed, Elsevier Science (Scopus) and Clarivate Analytics (Web of Science) over the past 20 years to identify the features of the above processes, after which a formalized content analysis of the found publications was carried out. Theoretically, every factor that disrupts the enterohepatic circulation leads to pathologies of the hepatobiliary system. However, there are still many unknown aspects when it comes to the regulation of bile acid homeostasis in the enterohepatic circulation. In the last few decades, it is believed that the most important prerequisites for the occurrence of hepatopathy are hypersecretion of bile cholesterol and supersaturation of bile with it. An equally important problem is the change in the pool of bile acids, since its various representatives differ both in chemical activity and in the mechanism of action (from cytotoxicity to cytoprotection).