Bile acid levels are increased in the liver of patients with steatohepatitis.
OBJECTIVE
The pathogenesis of steatohepatitis remains largely unknown; however, bile acids may play a role as potential mediators of liver damage. The aim of this study was to characterize bile acid profiles in liver tissue of patients with steatohepatitis.


METHODS
Bile acid composition was determined by gas-liquid chromatography in liver tissue from patients with nonalcoholic steatohepatitis (NASH; n=15), patients with alcoholic steatohepatitis (ASH; n=14), and controls (n=8). Liver biopsies were graded for steatosis, inflammation, and fibrosis.


RESULTS
Bile acids were moderately increased in liver tissue of steatohepatitis patients compared with controls (P<0.05). Deoxycholic, chenodeoxycholic, and cholic acids were elevated by 92, 64, and 43%, respectively, in patients with steatohepatitis (P<0.05). Cholic acid was the prevailing bile acid in NASH patients and in controls. More hydrophobic bile acid species were elevated in ASH patients compared with controls (P<0.05). Significant correlations were found in NASH patients between hepatic chenodeoxycholic acid and fibrosis, and between cholic acid and trihydroxy/dihydroxy bile acids and inflammation (P<0.05). In patients with ASH, cholic acid and trihydroxy/dihydroxy bile acids were correlated with steatosis (P<0.01).


CONCLUSIONS
This study shows a distinct pattern of bile acids in the liver of patients with steatohepatitis. Further, the association between bile acids and histological liver injury suggests an association of specific bile acids and disease progression, possibly through bile acid-induced liver injury.
Aranha
Márcia M
MM
Centro de Patogénese Molecular, Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal.
Cortez-Pinto
Helena
H
Costa
Adília
A
da Silva
Isabel B Moreira
IB
Camilo
Maria E
ME
de Moura
Miguel Carneiro
MC
Rodrigues
Cecília M P
CM
D000328:Adult; D001647:Bile Acids and Salts / Q000032:analysis*; D001706:Biopsy; D002635:Chenodeoxycholic Acid / Q000032:analysis; D019826:Cholic Acid / Q000032:analysis; D002849:Chromatography, Gas / Q000379:methods; D003840:Deoxycholic Acid / Q000032:analysis; D018450:Disease Progression; D005234:Fatty Liver / Q000378:metabolism* / Q000473:pathology; D005235:Fatty Liver, Alcoholic / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000737:chemistry* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
D001647:Bile Acids and Salts; D003840:Deoxycholic Acid; D002635:Chenodeoxycholic Acid; D019826:Cholic Acid