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1.
J Nutr ; 151(3): 523-530, 2021 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-33438034

RESUMO

BACKGROUND: Primary 12α-hydroxylated bile acids (12αOH BAs) enhance intestinal iron uptake due to their ability ex vivo to chelate iron. However, no information is available on their role in vivo, especially in the liver. OBJECTIVES: To investigate the effects and mechanisms of primary 12αOH BAs on hepatic iron concentration in vivo. METHODS: Male Wistar King A Hokkaido male rats (WKAH/HkmSlc) rats aged 4-5 weeks were fed a control diet or a diet with cholic acid (CA; 0.5 g/kg diet), the primary 12αOH BA, for 2 weeks (Study 1) or 13 weeks (Study 2). In Study 3, rats fed the same diets were given drinking water either alone or containing vancomycin (200 mg/L) for 6 weeks. The variables measured included food intake (Studies 1-3), bile acid profiles (Studies 1 and 3), hepatic iron concentration (Studies 1-3), fecal iron excretion (Studies 1 and 2), iron-related liver gene expression (Studies 2 and 3), and plasma iron-related factors (Studies 2 and 3). RESULTS: In Study 1, CA feed reduced the hepatic iron concentration (-16%; P = 0.005) without changing food intake or fecal iron excretion. In Study 2, we found a significant increase in the aortic plasma concentration of lipocalin 2 (LCN2; +65%; P < 0.001), an iron-trafficking protein. In Study 3, we observed no effect of vancomycin treatment on the CA-induced reduction of hepatic iron concentration (-32%; P < 0.001), accompanied by increased plasma LCN2 concentration (+72%; P = 0.003), in the CA-fed rats despite a drastic reduction in the secondary 12αOH BA concentration (-94%; P < 0.001) in the aortic plasma. CONCLUSIONS: Primary 12αOH BAs reduced the hepatic iron concentration in rats. LCN2 may be responsible for the hepatic iron-lowering effect of primary 12αOH BAs by transporting iron out of the liver.


Assuntos
Ácidos e Sais Biliares/análise , Ácido Cólico/administração & dosagem , Ácido Cólico/análise , Ferro/metabolismo , Fígado/metabolismo , Animais , Ácido Cólico/sangue , Ingestão de Alimentos , Expressão Gênica , Ferro/sangue , Lipocalina-2/sangue , Masculino , Ratos , Ratos Wistar , Reação em Cadeia da Polimerase em Tempo Real , Vancomicina/administração & dosagem
2.
Int J Mol Sci ; 19(1)2017 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-29283379

RESUMO

The development of radiation countermeasures for acute radiation syndrome (ARS) has been underway for the past six decades, leading to the identification of multiple classes of radiation countermeasures. However, to date, only two growth factors (Neupogen and Neulasta) have been approved by the United States Food and Drug Administration (US FDA) for the mitigation of hematopoietic acute radiation syndrome (H-ARS). No radioprotector for ARS has been approved by the FDA yet. Gamma-tocotrienol (GT3) has been demonstrated to have radioprotective efficacy in murine as well as nonhuman primate (NHP) models. Currently, GT3 is under advanced development as a radioprotector that can be administered prior to radiation exposure. We are studying this agent for its safety profile and efficacy using the NHP model. In this study, we analyzed global metabolomic and lipidomic changes using ultra-performance liquid chromatography (UPLC) quadrupole time-of-flight mass spectrometry (QTOF-MS) in serum samples of NHPs administered GT3. Our study, using 12 NHPs, demonstrates that alterations in metabolites manifest only 24 h after GT3 administration. Furthermore, metabolic changes are associated with transient increase in the bioavailability of antioxidants, including lactic acid and cholic acid and anti-inflammatory metabolites 3 deoxyvitamin D3, and docosahexaenoic acid. Taken together, our results show that the administration of GT3 to NHPs causes metabolic shifts that would provide an overall advantage to combat radiation injury. This initial assessment also highlights the utility of metabolomics and lipidomics to determine the underlying physiological mechanisms involved in the radioprotective efficacy of GT3.


Assuntos
Cromanos/farmacocinética , Metabolismo dos Lipídeos/efeitos dos fármacos , Metaboloma/efeitos dos fármacos , Protetores contra Radiação/farmacocinética , Vitamina E/análogos & derivados , Síndrome Aguda da Radiação/sangue , Síndrome Aguda da Radiação/prevenção & controle , Animais , Antioxidantes/metabolismo , Disponibilidade Biológica , Colecalciferol/análogos & derivados , Colecalciferol/sangue , Ácido Cólico/sangue , Cromanos/sangue , Ácidos Docosa-Hexaenoicos/sangue , Feminino , Humanos , Ácido Láctico/sangue , Macaca mulatta , Masculino , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Vitamina E/sangue , Vitamina E/farmacocinética
3.
J Biol Regul Homeost Agents ; 31(4): 1087-1093, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29254319

RESUMO

Bergamot polyphenolic fraction (BPF) has been shown to positively modulate several mechanisms involved in metabolic syndrome, suggesting its use in therapy. In particular, it is able to induce a significant amelioration of serum lipid profile in hyperlipemic patients at different levels. The purpose of our study was to investigate the effect of BPF on cholesterol absorption physiologically mediated by pancreatic cholesterol ester hydrolase (pCEH). An in vitro activity assay was performed to study the effect of BPF on pCEH, whereas the rate of cholesterol absorption was evaluated through in vivo studies. In particular, male, Sprague-Dawley rats (200–225 g) were fed either normal chow or chow supplemented with 0.5% cholic acid, 5.5% peanut oil, and varying amounts of cholesterol (0 to 1.5%). BPF (10 mg/Kg) was daily administrated by means of a gastric gavage to animals fed with lipid supplemented diet for 4 weeks and, at the end of the study, plasma lipids and liver cholesteryl esters were measured in all experimental groups. Our results show that BPF was able to inhibit pCEH activity and this effect was confirmed, in vivo, via detection of lymphatic cholesteryl ester in rats fed with a cholesterol-rich diet. This evidence clarifies a further mechanism responsible for the hypolipemic properties of BPF previously observed in humans, confirming its beneficial effect in the therapy of hypercholesterolemia and in the treatment of metabolic syndrome.


Assuntos
Suplementos Nutricionais , Hiperlipidemias/tratamento farmacológico , Hipolipemiantes/farmacologia , Óleos de Plantas/farmacologia , Esterol Esterase/antagonistas & inibidores , Animais , Colesterol/administração & dosagem , Colesterol/sangue , Ésteres do Colesterol/sangue , Ácido Cólico/administração & dosagem , Ácido Cólico/sangue , Absorção Gastrointestinal/fisiologia , Humanos , Hiperlipidemias/metabolismo , Hiperlipidemias/patologia , Hipolipemiantes/metabolismo , Fígado/efeitos dos fármacos , Fígado/metabolismo , Masculino , Síndrome Metabólica/tratamento farmacológico , Síndrome Metabólica/metabolismo , Síndrome Metabólica/patologia , Óleos de Plantas/metabolismo , Ratos , Ratos Sprague-Dawley , Esterol Esterase/metabolismo , Triglicerídeos/sangue
4.
J Proteome Res ; 16(10): 3529-3535, 2017 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-28841024

RESUMO

The evaluation of individual variability in endogenous drugs' metabolism and disposition is a very challenging task. We developed and validated a metabotype to pharmacokinetics (PK) matching approach by taking cholic acid as an example to predict the individualized PK of endogenous drugs. The stable isotope-labeled cholic acid was selected as the substitute analyte of cholic acid to ensure the accurate measurement of blood concentration. First, large-scale metabolite profiling studies were performed on the predose urine samples of 28 rats. Then, to examine the individualized PK of deuterium 4-cholic acid (d4-cholic acid) in these rats, we determined its plasma concentrations and calculated the differential AUC values. Subsequently, we conducted a two-stage partial least-squares analysis in which 31 baseline metabolites were screened initially for predicting the individualized AUC values of d4-cholic acid using the data of predose urine metabolites. Finally, network biology analysis was applied to give the biological interpretation of the individual variances in cholic acid metabolism and disposition, and the result further narrowed the selection of baseline metabolites from 31 to 2 (sarcosine and S-adenosyl-l-homocysteine) for such prediction. Collectively, this pharmacometabolomics research provided a new strategy for predicting individualized PK of endogenous drugs.


Assuntos
Ácido Cólico/farmacocinética , Metaboloma/genética , Metabolômica , Animais , Área Sob a Curva , Ácido Cólico/sangue , Ácido Cólico/urina , Humanos , Marcação por Isótopo , Ratos
5.
Am J Physiol Gastrointest Liver Physiol ; 311(1): G91-G104, 2016 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-27151938

RESUMO

Hepatocellular carcinoma (HCC) is the most common hepatic malignancy and the third leading cause of cancer related deaths. Previous studies have implicated bile acids in pathogenesis of HCC, but the mechanisms are not known. We investigated the mechanisms of HCC tumor promotion by bile acids the diethylnitrosamine (DEN)-initiation-cholic acid (CA)-induced tumor promotion protocol in mice. The data show that 0.2% CA treatment resulted in threefold increase in number and size of DEN-induced liver tumors. All tumors observed in DEN-treated mice were well-differentiated HCCs. The HCCs observed in DEN-treated CA-fed mice exhibited extensive CD3-, CD20-, and CD45-positive inflammatory cell aggregates. Microarray-based global gene expression studies combined with Ingenuity Pathway Analysis revealed significant activation of NF-κB and Nanog in the DEN-treated 0.2% CA-fed livers. Further studies showed significantly higher TNF-α and IL-1ß mRNA, a marked increase in total and phosphorylated-p65 and phosphorylated IκBα (degradation form) in livers of DEN-treated 0.2% CA-fed mice. Treatment of primary mouse hepatocytes with various bile acids showed significant induction of stemness genes including Nanog, KLF4, Sox2, and Oct4. Quantification of total and 20 specific bile acids in liver, and serum revealed a tumor-associated bile acid signature. Finally, quantification of total serum bile acids in normal, cirrhotic, and HCC human samples revealed increased bile acids in serum of cirrhotic and HCC patients. Taken together, these data indicate that bile acids are mechanistically involved pathogenesis of HCC and may promote HCC formation via activation of inflammatory signaling.


Assuntos
Carcinoma Hepatocelular/induzido quimicamente , Transformação Celular Neoplásica/induzido quimicamente , Ácido Cólico/toxicidade , Dietilnitrosamina , Mediadores da Inflamação/metabolismo , Neoplasias Hepáticas Experimentais/induzido quimicamente , Adulto , Animais , Apoptose/efeitos dos fármacos , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/metabolismo , Carcinoma Hepatocelular/patologia , Proliferação de Células/efeitos dos fármacos , Transformação Celular Neoplásica/genética , Transformação Celular Neoplásica/metabolismo , Transformação Celular Neoplásica/patologia , Células Cultivadas , Ácido Cólico/sangue , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Feminino , Regulação Neoplásica da Expressão Gênica , Hepatócitos/efeitos dos fármacos , Hepatócitos/metabolismo , Hepatócitos/patologia , Humanos , Fator 4 Semelhante a Kruppel , Neoplasias Hepáticas Experimentais/genética , Neoplasias Hepáticas Experimentais/metabolismo , Neoplasias Hepáticas Experimentais/patologia , Masculino , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Proteínas Quinases Ativadas por Mitógeno/metabolismo , NF-kappa B/metabolismo , Células-Tronco Neoplásicas/efeitos dos fármacos , Células-Tronco Neoplásicas/metabolismo , Células-Tronco Neoplásicas/patologia , Transdução de Sinais/efeitos dos fármacos , Carga Tumoral/efeitos dos fármacos , Adulto Jovem
6.
Obesity (Silver Spring) ; 22(2): 390-400, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23804416

RESUMO

OBJECTIVE: Our objective was to investigate the role of bile acids in hepatic steatosis reduction after vertical sleeve gastrectomy (VSG). DESIGN AND METHODS: High fat diet (HFD)-induced obese C57Bl/6 mice were randomized to VSG, Sham operation (Sham), Sham operation with pair feeding to VSG (Sham-PF), or nonsurgical controls (Naïve). All mice were on HFD until sacrifice. Mice were observed postsurgery and data for body weight, body composition, metabolic parameters, serum bile acid level and composition were collected. Further hepatic gene expression by mRNA-seq and RT-PCR analysis was assessed. RESULTS: VSG and Sham-PF mice lost equal weight postsurgery while VSG mice had the lowest hepatic triglyceride content at sacrifice. The VSG mice had elevated serum bile acid levels that positively correlated with maximal weight loss. Serum bile composition in the VSG group had increased cholic and tauroursodeoxycholic acid. These bile acid composition changes in VSG mice explained observed downregulation of hepatic lipogenic and bile acid synthetic genes. CONCLUSION: VSG in obese mice results in greater hepatic steatosis reduction than seen with caloric restriction alone. VSG surgery increases serum bile acids that correlate with weight lost postsurgery and changes serum bile composition that could explain suppression of hepatic genes responsible for lipogenesis.


Assuntos
Ácidos e Sais Biliares/sangue , Fígado Gorduroso/prevenção & controle , Gastroplastia , Fígado/metabolismo , Obesidade/cirurgia , Regulação para Cima , Redução de Peso , Animais , Ácidos e Sais Biliares/metabolismo , Restrição Calórica , Ácido Cólico/sangue , Ácido Cólico/metabolismo , Dieta Hiperlipídica/efeitos adversos , Regulação para Baixo , Fígado Gorduroso/etiologia , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Lipogênese , Fígado/patologia , Fígado/fisiopatologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Hepatopatia Gordurosa não Alcoólica , Obesidade/metabolismo , Obesidade/patologia , Obesidade/fisiopatologia , Período Pós-Prandial , Distribuição Aleatória , Ácido Tauroquenodesoxicólico/sangue , Ácido Tauroquenodesoxicólico/metabolismo , Triglicerídeos/metabolismo
7.
Talanta ; 93: 364-70, 2012 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-22483924

RESUMO

Molecular imprinted polymers (MIPs) as a recognition element for sensors are increasingly of interest and MIP-nanoparticles have started to appear in the literature. In this study, we have proposed a novel thiol ligand-capping method with polymerizable methacryloylamido-cysteine (MAC) attached to gold-silver-nanoclusters reminiscent of a self-assembled monolayer and have reconstructed surface shell by synthetic host polymers based on molecular imprinting method for cholic acid recognition. In this method, methacryloylamidohistidine-Pt(II) [MAH-Pt(II)] has used as a new metal-chelating monomer via metal coordination-chelation interactions and cholic acid. Nanoshell sensors with templates give a cavity that is selective for cholic acid. The cholic acid can simultaneously chelate to Pt(II) metal ion and fit into the shape-selective cavity. Thus, the interaction between Pt(II) ion and free coordination spheres has an effect on the binding ability of the gold-silver-nanoclusters nanosensor. The binding affinity of the cholic acid imprinted nanoparticles have investigated by using the Langmuir and Scatchard methods and determined affinity constant (K(affinity)) has found to be 2.73 × 10(4) mol L(-1) and 2.13 × 10(8) mol L(-1), respectively. At the last step of this procedure, cholic acid level in blood serum and urine which belong to a healthy people were determined by the prepared gold-silver-nanoclusters.


Assuntos
Ácido Cólico/química , Ouro/química , Nanopartículas Metálicas/química , Impressão Molecular , Prata/química , Ácido Cólico/análise , Ácido Cólico/sangue , Ácido Cólico/urina , Cisteína/química , Humanos , Medições Luminescentes , Polimerização , Compostos de Sulfidrila/química
8.
Hepatogastroenterology ; 59(118): 1804-8, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22369744

RESUMO

BACKGROUND/AIMS: Evaluation of bile acids (BA) is useful for assessing the changes of intestinal flora in patients with ulcerative colitis (UC). During enterohepatic circulation, the intestinal micro flora cause 7 alpha-dehydroxylation of cholic acid (CA) and chenodeoxycholic acid (CDCA), yielding deoxycholic acid(DCA) and lithocholic acid, respectively. The aim of the present study was to investigate the effects of probiotics in patients with UC by examining changes of the serum BA profile. METHODOLOGY: Twenty-seven patients were divided into the following 2 groups based on endoscopic findings: Fifteen patients with distal UC (dUC group) and 12 patients with pancolitis (pUC group). After treatment with mesalazine or salazosulfapyridine (5-ASA), all patients achieved remission. Then they were given 5-ASA plus the probiotic Clostridium butyricum Miyairi (3.0 g/day) for 4 weeks. RESULTS: After 4 weeks of probiotic treatment, %CDCA was significantly higher and %DCA was significantly lower in the pUC group than in the HV group. In contrast, the dUC group showed no significant differences of %CDCA or %DCA from the HV group after 4 weeks. CONCLUSIONS: Probiotic therapy restored intestinal flora involved in 7 alpha-dehydroxylation in the dUC group, but not in the pUC group.


Assuntos
Ácidos e Sais Biliares/sangue , Clostridium butyricum/crescimento & desenvolvimento , Colite Ulcerativa/terapia , Intestinos/microbiologia , Probióticos/uso terapêutico , Adulto , Idoso , Biomarcadores/sangue , Biópsia , Ácido Quenodesoxicólico/sangue , Ácido Cólico/sangue , Doença Crônica , Colite Ulcerativa/sangue , Colite Ulcerativa/microbiologia , Colite Ulcerativa/patologia , Endoscopia Gastrointestinal , Feminino , Fármacos Gastrointestinais/uso terapêutico , Humanos , Intestinos/patologia , Japão , Ácido Litocólico/sangue , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Fatores de Tempo , Resultado do Tratamento
10.
Clin Sci (Lond) ; 102(5): 587-93, 2002 May.
Artigo em Inglês | MEDLINE | ID: mdl-11980579

RESUMO

The aim of this study was to identify a subgroup of pregnant women with asymptomatic hypercholanaemia of pregnancy (AHP), in which the relationship between alterations in the level and pattern of serum bile acids (BAs) and of progesterone plus progesterone metabolites could be investigated in the absence of overt impairment of hepatobiliary function. Cholanaemia and serum concentrations of progesterone were assayed by an enzymic technique and by ELISA respectively, while BA molecular species and progesterone metabolites were measured by GC-MS, in the serum of 411 healthy pregnant women. Samples were collected after an overnight fast in the final week of each trimester of gestation. Two pregnant women were excluded because of the suspicion of intrahepatic cholestasis of pregnancy (ICP). Cholanaemia was found to increase progressively throughout pregnancy, but with normal mean values lower than 3.0 microM. Thus in our series AHP was defined arbitrarily as the presence of serum total BA concentrations 2-fold higher than this value, i.e. 6 microM, in the absence of hepatobiliary disease or symptoms of ICP. The prevalence of this condition was observed to increase with gestational age. Changes in the pattern of serum BAs in AHP were also found. These were reflected in a marked increase in the proportion of cholic acid together with a decrease in that of deoxycholic acid, while the proportions of chenodeoxycholic acid and lithocholic acid changed only moderately. When groups at the same gestational age were compared, serum progesterone levels were always significantly lower, while those of progesterone metabolites were higher, in women with AHP. Our results suggest that AHP is a relatively common condition in our geographical location, where ICP is rarely diagnosed. Changes in the serum BA pattern in hypercholanaemia resemble these described in ICP. The simultaneous finding of lower serum total progesterone levels along with an increase in its metabolites supports the hypothesis that a primary defect in progesterone metabolism may be involved in the aetiology of ICP.


Assuntos
Ácidos e Sais Biliares/sangue , Complicações na Gravidez/sangue , Progesterona/sangue , Adulto , Ácido Cólico/sangue , Ácido Desoxicólico/sangue , Feminino , Seguimentos , Cromatografia Gasosa-Espectrometria de Massas , Idade Gestacional , Humanos , Gravidez
11.
J Inherit Metab Dis ; 25(6): 501-13, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12555943

RESUMO

Follow-up investigations were undertaken on a previously reported patient who had severe familial giant cell hepatitis in infancy associated with substantially increased urinary excretion of bile alcohol glucuronides. By the age of 11 years, he had developed a profile of cholanoids in plasma and urine that closely resembled the pattern seen in cerebrotendinous xanthomatosis (CTX). Sequencing of the sterol 27-hydroxylase gene (CYP27A) showed that he was homozygous for a deletion (525/526delG) that causes a frameshift and a premature stop codon. This genotype has previously been described in an adult female with classical symptoms of CTX (tendon xanthomata, cataracts and deteriorating cognitive function). A review of past medical histories of a group of patients with CTX revealed that prolonged neonatal cholestatic jaundice was common. The family histories also revealed fetal and neonatal deaths among siblings of patients with CTX. We conclude that defective activity of cholesterol 27-hydroxylase can lead to neonatal cholestatic jaundice ('hepatitis of infancy'), which may be self-limiting. After a latent period, however, progressive accumulation of cholesterol and cholestanol can lead to the xanthomata, neurodegeneration, cataracts and atherosclerosis that are typical of CTX.


Assuntos
Hepatite/genética , Mutação/genética , Esteroide Hidroxilases/genética , Xantomatose Cerebrotendinosa/genética , Adolescente , Adulto , Ácido Quenodesoxicólico/sangue , Colestanotriol 26-Mono-Oxigenase , Colestanóis/urina , Colestase/etiologia , Ácido Cólico/sangue , DNA/genética , Éxons , Cromatografia Gasosa-Espectrometria de Massas , Hepatite/complicações , Humanos , Masculino , Xantomatose Cerebrotendinosa/complicações
12.
Hepatogastroenterology ; 47(35): 1223-6, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11100318

RESUMO

BACKGROUND/AIMS: Phospholipase A2 activity is reported to be related to the physiology of various disorders, and the activity is modified by deoxycholic acid. METHODOLOGY: Serum phospholipase A2 activity was measured by counting the radioactivity of 14C-palmitic acid released from L-3-phosphatidylcholine (1-palmitoyl-2-14C-palmitoyl) in 40 patients with hyperbilirubinemia due to malignant neoplasms and benign cholestasis. Phospholipase A2 activity in serum from healthy subjects was also measured after incubation with 5-30 mg of bilirubin per dL or 0.1-5 mM of cholic acid for 60 min at 37 degrees C. RESULTS: Serum phospholipase A2 activity was significantly lower in patients with hyperbilirubinemia. There were negative correlations between serum phospholipase A2 activity and concentration of total bilirubin (r = 0.668; P < 0.0001) or total bile acids (r = 0.423; P < 0.05) in patients with hyperbilirubinemia. In 12 patients who underwent percutaneous transhepatic biliary drainage, the low serum phospholipase A2 activity was reversed while bilirubin concentrations decreased. Incubation of sera from healthy subjects with more than 3 mM cholic acid significantly reduced phospholipase A2 activity (P < 0.01), whereas incubation with bilirubin had no effect. CONCLUSIONS: Inhibition of serum phospholipase A2 activity in patients with hyperbilirubinemia may be caused by increased serum cholic acid concentration.


Assuntos
Hiperbilirrubinemia/enzimologia , Fosfolipases A/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Ácidos e Sais Biliares/sangue , Bilirrubina/sangue , Radioisótopos de Carbono , Ácido Cólico/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fosfolipases A2
13.
Gastroenterology ; 119(1): 188-95, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10889168

RESUMO

BACKGROUND & AIMS: The mechanism for abnormal hepatic bile acid transport was investigated in an 18-month-old Amish boy who presented with pruritus, poor growth, and severe bleeding episodes. Serum bilirubin, gamma-glutamyltranspeptidase, and cholesterol levels were normal, but prothrombin time and partial thromboplastin time were prolonged and bone alkaline phosphatase level was elevated. METHODS AND RESULTS: Cholic acid plus chenodeoxycholic acid levels measured by capillary gas-chromatography were 32 times higher than control in serum (34.7 vs. 1.1+/-0.4 microg/dL) but were not detected in liver and were reduced in gallbladder bile. Treatment with ursodiol, a more hydrophilic bile acid, improved pruritus, produced 37% weight gain, and after 2 years reduced serum primary bile acid concentrations about 85%, while accounting for 71% of serum and 24% of biliary bile acid conjugates. On ursodiol therapy, hepatic bile acid synthesis was enhanced 2-fold compared with controls, and microscopy revealed chronic hepatitis without cholestasis. Three younger sisters with elevated serum bile acids responded positively to ursodiol. Microsatellite markers for the FIC1 (gene for Byler's disease) region in these 4 children were inconsistent with linkage to FIC1. CONCLUSIONS: Conjugated cholic acid and chenodeoxycholic acid were synthesized in the liver and secreted into bile but could not reenter the liver from portal blood and accumulated in serum. In contrast, unconjugated ursodiol entered the liver and was conjugated and secreted into bile. Thus, the enterohepatic circulation of all conjugated bile acids was interrupted at the hepatic sinusoidal basolateral membrane. Unconjugated ursodiol bypassed the hepatic uptake block to enlarge the biliary and intestinal bile acid pools. A mutation in FIC1 recognized among the Amish and linkage of the disorder to FIC1 were excluded.


Assuntos
Adenosina Trifosfatases/genética , Ácidos e Sais Biliares/metabolismo , Colagogos e Coleréticos/uso terapêutico , Etnicidade/genética , Ligação Genética/genética , Fígado/metabolismo , Ácido Ursodesoxicólico/uso terapêutico , Ácidos e Sais Biliares/biossíntese , Transporte Biológico/efeitos dos fármacos , Ácido Quenodesoxicólico/sangue , Ácido Quenodesoxicólico/urina , Colagogos e Coleréticos/metabolismo , Ácido Cólico/sangue , Ácido Cólico/urina , Feminino , Humanos , Lactente , Masculino , Linhagem , Pennsylvania/etnologia , Ácido Ursodesoxicólico/metabolismo
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