Ileal absorption of bile acids in patients with chronic cholestasis: SeHCAT test results and effect of ursodeoxycholic acid (UDCA).

Abstract

The effect of cholestasis on ileal bile acid absorption is controversial in animal models (up- or down-regulation) and unknown in humans. We therefore studied values of the selena homotaurocholic acid (SeHCAT) test before and after long-term administration (>3 months, 13-15 mg/kg/day) of ursodeoxycholic acid (UDCA) in 27 patients with chronic cholestatic liver diseases (24 women, 3 men; mean age, 50 years; 24 primary biliary cirrhosis, 2 secondary biliary cirrhosis, 2 others). The control group consisted of 14 healthy volunteers. Seven-day SeHCAT percentage retention was identical in the 12 untreated cholestatic patients (serum bilirubin, 75+/-42 micromol/L, alkaline phosphatase, 4.2+/-1.0 N; mean+/-SEM) and in the control group (43.6+/-2.9 and 43.8+/-4.2%, respectively). In the 22 patients treated by UDCA for 38+/-8 months, SeHCAT percentage retention was 20.3+/-3.0%. In the seven patients with the SeHCAT test done before and after UDCA treatment (16+/-5 months), SeHCAT percentage retention decreased significantly under UDCA therapy (42.0+/-4.4 vs 19.4+/-4.1%; P < 0.02). We conclude that, in patients with chronic cholestasis (1) SeHCAT percentage retention is not altered-taken together with the known defect of biliary excretion, this lack of increase in SeHCAT percentage retention argues against up-regulation of bile acid ileal transport; and (2) UDCA treatment induces a decrease in the SeHCAT percentage retention-this effect may be related primarily to a decreased bile acid ileal absorption.

• Authors: O Chazouillères, P Marteau, M Haniche, R Jian, R Poupon
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 41 Issue 12 Pg. 2417-22 (Dec 1996) ISSN: 0163-2116 [Print] United States
• PMID: 9011452 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article)

Chemical References

• Bile Acids and Salts
• Selenium Radioisotopes
• Taurocholic Acid
• Ursodeoxycholic Acid
• 23-seleno-25-homotaurocholic acid
• gamma-Glutamyltransferase
• Alkaline Phosphatase

Topics

• Alkaline Phosphatase (metabolism)
• Bile Acids and Salts (metabolism)
• Cholestasis (complications, drug therapy, metabolism)
• Chronic Disease
• Down-Regulation
• Female
• Humans
• Ileum (metabolism)
• Intestinal Absorption
• Liver Cirrhosis (complications)
• Male
• Middle Aged
• Selenium Radioisotopes (blood)
• Taurocholic Acid (analogs & derivatives, blood)
• Up-Regulation
• Ursodeoxycholic Acid (therapeutic use)
• gamma-Glutamyltransferase (metabolism)