Bile acid analysis in human disorders of bile acid biosynthesis.
Bile acids facilitate the absorption of lipids in the gut, but are also needed to maintain cholesterol homeostasis, induce bile flow, excrete toxic substances and regulate energy metabolism by acting as signaling molecules. Bile acid biosynthesis is a complex process distributed across many cellular organelles and requires at least 17 enzymes in addition to different metabolite transport proteins to synthesize the two primary bile acids, cholic acid and chenodeoxycholic acid. Disorders of bile acid synthesis can present from the neonatal period to adulthood and have very diverse clinical symptoms ranging from cholestatic liver disease to neuropsychiatric symptoms and spastic paraplegias. This review describes the different bile acid synthesis pathways followed by a summary of the current knowledge on hereditary disorders of human bile acid biosynthesis with a special focus on diagnostic bile acid profiling using mass spectrometry.
Department of Clinical Chemistry and Pediatrics, Laboratory Genetic Metabolic Diseases, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: f.m.vaz@amc.nl.
Frédéric M
FM
Vaz
Department of Clinical Chemistry and Pediatrics, Laboratory Genetic Metabolic Diseases, Academic Medical Center, Amsterdam, The Netherlands.
Sacha
S
Ferdinandusse
D000328:Adult; D000818:Animals; D002635:Chenodeoxycholic Acid / Q000032:analysis / Q000096:biosynthesis*; D002779:Cholestasis / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics / Q000473:pathology; D002784:Cholesterol / Q000032:analysis / Q000378:metabolism; D019826:Cholic Acid / Q000032:analysis / Q000096:biosynthesis*; D004764:Enterohepatic Circulation; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007223:Infant; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000382:microbiology; D008099:Liver / Q000166:cytology / Q000378:metabolism; D013058:Mass Spectrometry / Q000295:instrumentation / Q000379:methods; D015419:Spastic Paraplegia, Hereditary / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics / Q000473:pathology; D015211:Zellweger Syndrome / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics / Q000473:pathology
D002635:Chenodeoxycholic Acid; D002784:Cholesterol; D019826:Cholic Acid
Bile acid biosynthesis; Inborn errors of metabolism; Mass spectrometry