title: Effect of long-term treatment with ursodiol on clinical and biochemical features and biliary bile acid metabolism in patients with primary biliary cirrhosis.
abstract: The effect of ursodiol on the clinical and biochemical features, serum, urinary, and biliary bile acids was investigated over a 2-yr treatment period in 14 patients with primary biliary cirrhosis (stages II-IV). Pruritus and fatigue improved, and alkaline phosphatase and liver transferases declined significantly in all patients during therapy. In four patients, less inflammation was noted by liver biopsy after 2 yr, but histology of disease did not change. Serum and urinary bile acids were increased several-fold before treatment, with cholic acid predominating. Ursodiol accounted for 30% of biliary bile acids after administration (gallstone subjects approximately 50%), and was conjugated with glycine and taurine in a ratio of 7.3:1. However, in the endogenous bile acids, the ratio increased from 1.2:1 to only 2.1:1. About 6% unconjugated bile acids were secreted into the bile (healthy controls < 1%). Thus, in patients with primary biliary cirrhosis, a larger fraction of free bile acids and a higher proportion of taurine-conjugated bile acids are secreted into the bile, compared with healthy controls. Ursodiol improves symptoms and histology with lower biliary enrichment with this bile acid.
authors: Department of Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark.
authors: A K
authors: AK
authors: Batta
authors: G
authors: G
authors: Salen
authors: R
authors: R
authors: Mirchandani
authors: G S
authors: GS
authors: Tint
authors: S
authors: S
authors: Shefer
authors: M
authors: M
authors: Batta
authors: J
authors: J
authors: Abroon
authors: C B
authors: CB
authors: O'Brien
authors: J R
authors: JR
authors: Senior
mesh_terms: D001646:Bile / Q000737:chemistry; D001647:Bile Acids and Salts / Q000378:metabolism*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
chemical_list: D001647:Bile Acids and Salts; D014580:Ursodeoxycholic Acid