BILE ACIDS IN THE DIAGNOSIS, PATHOLOGY, AND THERAPY OF HEPATOBILIARY DISEASES

摘要

Bile acids, which undergo extensive enterohepatic circulation, play an important role in bile formation, biliary lipid excretion, and intestinal lipid absorption. In hepatobiliary diseases, bile acids escape the confinement of the enterohepatic circulation, allowing the measurement of the serum total bile acid concentration as a diagnostic indicator. Accumulation of certain bile acids within the hepatocyte, amplified as a consequence of cholestatic hepatobiliary disease, probably enhances cytotoxicity and leads to secondary pathology. Ursodeoxycholate, a bile acid with atypical physiologic effects, may be useful in the treatment of various chronic cholestatic hepatobiliary diseases. Diagnostic and prognostic values of serum bile acid levels as well as postulated mechanisms of cytotoxic and therapeutic effects of bile acids are discussed.