title: Effect of Inhibition of Intestinal Cholesterol Absorption on the Prevention of Cholesterol Gallstone Formation.
abstract: BACKGROUND
  Cholesterol cholelithiasis is a multifactorial hepatobiliary disease.
  
  
  METHODS
  Interactions between genetic and environmental factors play a critical role in biliary cholesterol homeostasis and its imbalance enhances cholelithogenesis.
  
  
  RESULTS
  In patients developing symptoms or complications of gallstone disease, laparoscopic cholecystectomy is recommended for treatment of gallstones. In a subgroup of patients with small, radiolucent pure cholesterol gallstones, the hydrophilic bile acid, ursodeoxycholic acid (UDCA) is still considered the only pharmacological therapy able to induce oral litholysis. Identifying novel and effective pharmacological therapies is being investigated.
  
  
  CONCLUSIONS
  We propose that the specific intestinal Niemann-Pick C1-like 1 protein inhibitor ezetimibe is a potential agent for preventing gallstone formation by reducing bioavailability of intestine- derived cholesterol to the liver for biliary secretion and desaturating bile through the inhibition of intestinal absorption of cholesterol.
authors.affiliation: University of Bari Medical School, Clinica Medica "A. Murri"; Department of Biosciences and Human Oncology (DIMO); Policlinico Hospital - 70124 Bari, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Portincasa
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO 63104, United States.
authors.forename: David Q-H
authors.initials: DQ
authors.lastname: Wang
mesh_terms: D000818:Animals; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D002769:Cholelithiasis / Q000503:physiopathology / Q000517:prevention & control*; D002784:Cholesterol / Q000378:metabolism*; D000069438:Ezetimibe / Q000494:pharmacology*; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects*; D008565:Membrane Proteins / Q000037:antagonists & inhibitors; D026901:Membrane Transport Proteins
chemical_list: D000924:Anticholesteremic Agents; D008565:Membrane Proteins; D026901:Membrane Transport Proteins; C410800:NPC1L1 protein, human; D002784:Cholesterol; D000069438:Ezetimibe
keywords: Brush border; Niemann-Pick C1-like 1 protein; ezetimibe; gallstones; intestinal cholesterol absorption