title: Feasibility of low-dose and intermittent chenodeoxycholic acid therapy of gallstones.
abstract: Chenodeoxycholic acid, by reducing the concentration of biliary cholesterol relative to that of bile acid and phospholipid, dissolves cholesterol gallstones. This bile acid, however, has potential dose-related hepatotoxicity and causes dose-related diarrhea. Therefore, the feasibility of low-dose and intermittent therapy was assessed by studying the induction and persistence of chenodeoxycholic acid-induced biliary lipid changes. Biliary lipid composition with each of 3 doses of chenodeoxycholic acid was determined in bile samples obtained by cholecystokinin-stimulated duodenal drainage before, after one week and one month of treatment, and up to 9 weeks after discontinuation of treatment. The lowest dose that significantly reduced the relative concentration of biliary cholesterol was 250 mg/day. A significant reduction occurred one week after initiation of treatment and was maintained for 9 weeks following discontinuation of treatment. Thus, clinical trials on low-dose and intermittent chenodeoxycholic acid therapy for gallstone prophylaxis or dissolution are warranted.
mesh_terms: D000328:Adult; D000368:Aged; D001646:Bile / Q000378:metabolism; D002635:Chenodeoxycholic Acid / Q000008:administration & dosage* / Q000627:therapeutic use; D002769:Cholelithiasis / Q000188:drug therapy* / Q000517:prevention & control; D002784:Cholesterol / Q000378:metabolism; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000378:metabolism
chemical_list: D010743:Phospholipids; D002635:Chenodeoxycholic Acid; D002784:Cholesterol