Skip to main content
SpringerLink
Log in

The effectual level of ursodeoxycholic acid in therapy for non-advanced chronic cholestasis is fifty percent of total serum bile acids

  • Liver, Pancreas, and Biliary Tract
  • Published:
Gastroenterologia Japonica Aims and scope Submit manuscript

Summary

Ursodeoxycholic acid therapy (600 mg/day) was evaluated in twelve patients with nonadvanced chronic cholestasis. Within four months, ursodeoxycholic acid replaced more than 50% of total bile acids in 8 patients and the reduction of serum γ-glutamyltranspeptidase, alkaline phosphatase and transaminases averaged 30% or more. The serum levels of chenodeoxycholic acid depend on those of ursodeoxycholic acid, but are not related to those of biochemical parameters. Drug therapy was continued in three poor responders for 2–3 four-month periods. In one case an increase of the serum proportion of ursodeoxycholic acid was associated with a reduction in biochemical parameters. The other two cases had high serum levels of chenodeoxycholic acid and/or cholic acid throughout the entire course of treatment. While the treatment of chronic cholestasis requires an effectual serum proportion of ursodeoxycholic acid, it is important to distinguish endogenous persistent hyper-bile-acidemia from ursodeoxycholic acid-related acidemia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Jain S, Scheuer PJ, Samourian S, et al: A controlled trial of D-penicillamine in primary biliary cirrhosis. Lancet 1977;l:831–834.

    Article  Google Scholar 

  2. Crowe J, Christensen E, Smith M, et al: Azathioprine in primary biliary cirrhosis: a preliminary report of an international trial. Gastroenterology 1980;78:1005–1010.

    PubMed  CAS  Google Scholar 

  3. Kaplan MM, Ailing DW, Zimmerman HJ, et al: A prospective trial of colchicine for primary biliary cirrhosis. Gastroenterology 1986;92:255–257.

    Google Scholar 

  4. Fischer MM, Paradine ME: Influence of ursodeoxycholic acid (UDCA) on biochemical parameters in cholestatic liver disease (abstr). Gastroenterology 1986; 90:1725.

    Google Scholar 

  5. Poupon R, Chretien Y, Poupon RE, et al: Is ursodeoxycholic acid an effective treatment for primary biliary cirrhosis? Lancet 1987;2:834–836.

    Article  Google Scholar 

  6. Wada T, Koga Y, Yoshitake M, et al: Effect of UDCA on primary biliary cirrhosis. Clin Res 1987;64:2590–2594.

    Google Scholar 

  7. Okuyama S, Higuchi T, Ichimiya H, et al: A case of primary biliary cirrhosis: 4 year’s treatment with 300 mg/day ursodeoxycholic acid. Acta Hepat Jap 1988;29:799–802. (in Japanese)

    Google Scholar 

  8. Stiehl A, Raedsch B, Kommerell B: The effect of ursodeoxycholic acid (URSO) in primary sclerosing cholangitis. A comparison to primary biliary cirrhosis (abstr). Gastroenterology 1988; 94:A595.

    Google Scholar 

  9. Leuschner U, Fischer H, Kurtz W, et al: Ursodeoxycholic acid in primary biliary cirrhosis: results of a controlled double-blind trial. Gastroenterology 1989;97:1268–1274.

    PubMed  CAS  Google Scholar 

  10. Batta AK, Salen G, Arora R, et al: Effect of ursodeoxycholic acid metabolism in primary biliary cirrhosis. Hepatology 1989; 10:414–419.

    Article  PubMed  CAS  Google Scholar 

  11. Hofmann AF, Popper H: Ursodeoxycholic acid for primary biliary cirrhosis. Lancet 1987;2:398–399.

    Article  PubMed  CAS  Google Scholar 

  12. Salen G, Tint GS, Eliav B, et al: Increased formation of ursodeoxycholic acid in patients treated with chenodeoxycholic acid. J Clin Invest 1974;53:612–621.

    Article  PubMed  CAS  Google Scholar 

  13. Hirano S, Masuda N, Oda H. In vitro transformation of chenodeoxycholic acid and ursodeoxycholic acid by human intestinal flora, with particular reference to the mutual conversion between the two bile acids. J Lipid Res 1981;22:735–743.

    PubMed  CAS  Google Scholar 

  14. Nilsell K, Angelin B, Leijd B, et al: Comparative effects of ursodeoxycholic acid and chenodeoxycholic acid on bile acid kinetics and biliary lipid secretion in humans: evidence for different models of action on bile acid synthesis. Gastroenterology 1983;85:1248–1256.

    PubMed  CAS  Google Scholar 

  15. Scheuer JP: Liver biopsy interpretation. London: Bailliére Tindall. 1988;40-65.

  16. LiYeng C, Goldberg HI: Sclerosing cholangitis: broad spectrum of radiographic features. Gastrointest Radiol 1984;9:39–47.

    Article  Google Scholar 

  17. Okuyama S, Kokubun N, Higashidate S, et al: A new analytical method of individual bile acids using high performance liquid chromatography and immobilized 3α-hydroxysteroid dehydrogenase in column form. Chem Lett. 1979;1443-1446.

  18. Kitani K, Kanai S: Tauroursodeoxycholate prevents taurocholate induced cholestasis. Life Sci 1982;30:515–523.

    Article  PubMed  CAS  Google Scholar 

  19. Kitani K, Kitani S: Effect of ursodeoxycholate on the bile flow in the rat. Life Sci 1982;31:1973–1985.

    Article  PubMed  CAS  Google Scholar 

  20. Miyazaki K, Nakayama F, Koga A: Effect of chenodeoxycholic and ursodeoxycholic acids on isolated human hepatocytes. Dig Dis Sci 1984;19:1123–1130.

    Article  Google Scholar 

  21. Yamanaka M, Ohto M, Obata H, et al: Ursodeoxycholic acid for treatment of chronic hepatitis. A double-blind controlled study. Diag Treat 1976;64:2150–2157.

    Google Scholar 

  22. Leuschner U, Leuschner M, Sieratzki J, et al: Gallstone dissolution with ursodeoxycholic acid in patient with chronic active hepatitis and two years follow-up. A pilot study. Dig Dis Sci 1985;30:642–649.

    Article  CAS  Google Scholar 

  23. Bellentani S, Tabarroni G, Barchi T, et al: Effect of ursodeoxycholic acid treatment on alanine aminotransferase and γ-glutamyl-transpeptidase serum levels in patients with hypertransaminasemia. Results from a double-blind controlled trial. J Hepatology 1989;8:7–12.

    Article  CAS  Google Scholar 

  24. Tokyo Cooperative Gallstone Study Group: Efficacy and indications of ursodeoxycholic acid treatment for dissolving gallstones: a multicenter double-blind trial. Gastroenterology 1980;78:542–548.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Third Department of Medicine, Nagoya University School of Medicine, 65 Tsuruma-cho, Showa-ku, 466, Nagoya, Japan

    Tomoyuki Higuchi, Naoki Hishida, Toyoshi Isomura, Hirotomo Takeshima & Hisao Hayashi M.D.

Authors
  1. Tomoyuki Higuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Naoki Hishida
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toyoshi Isomura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hirotomo Takeshima
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hisao Hayashi M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Higuchi, T., Hishida, N., Isomura, T. et al. The effectual level of ursodeoxycholic acid in therapy for non-advanced chronic cholestasis is fifty percent of total serum bile acids. Gastroenterol Jpn 27, 222–229 (1992). https://doi.org/10.1007/BF02777726

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02777726

Key words

Search

Navigation