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Wu J, Chao Y, Kankala RK, Lee C, Liu C, Hu Y. Gallstone formation analysis using the particle appearance, the particle binding to calcium ions, and the cholesterol nucleation with time in supersaturated taurocholate–lecithin–calcium ion solutions. J CHIN CHEM SOC-TAIP 2020. [DOI: 10.1002/jccs.201900543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jhih‐Ru Wu
- Institute of Biotechnology and Department of Life Science National Dong–Hwa University Hualien Taiwan
| | - Yu‐Liang Chao
- Institute of Biotechnology and Department of Life Science National Dong–Hwa University Hualien Taiwan
| | - Ranjith Kumar Kankala
- Institute of Biotechnology and Department of Life Science National Dong–Hwa University Hualien Taiwan
- College of Chemical Engineering Huaqiao University Xiamen China
| | - Chia‐Hung Lee
- Institute of Biotechnology and Department of Life Science National Dong–Hwa University Hualien Taiwan
| | - Chen‐Lun Liu
- Institute of Biotechnology and Department of Life Science National Dong–Hwa University Hualien Taiwan
| | - Yu‐Fang Hu
- Pharmaceutical Drug Delivery Division TTY Biopharm Company Limited Taipei Taiwan
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Schonewille M, de Boer JF, Mele L, Wolters H, Bloks VW, Wolters JC, Kuivenhoven JA, Tietge UJF, Brufau G, Groen AK. Statins increase hepatic cholesterol synthesis and stimulate fecal cholesterol elimination in mice. J Lipid Res 2016; 57:1455-64. [PMID: 27313057 DOI: 10.1194/jlr.m067488] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Indexed: 12/19/2022] Open
Abstract
Statins are competitive inhibitors of HMG-CoA reductase, the rate-limiting enzyme of cholesterol synthesis. Statins reduce plasma cholesterol levels, but whether this is actually caused by inhibition of de novo cholesterol synthesis has not been clearly established. Using three different statins, we investigated the effects on cholesterol metabolism in mice in detail. Surprisingly, direct measurement of whole body cholesterol synthesis revealed that cholesterol synthesis was robustly increased in statin-treated mice. Measurement of organ-specific cholesterol synthesis demonstrated that the liver is predominantly responsible for the increase in cholesterol synthesis. Excess synthesized cholesterol did not accumulate in the plasma, as plasma cholesterol decreased. However, statin treatment led to an increase in cholesterol removal via the feces. Interestingly, enhanced cholesterol excretion in response to rosuvastatin and lovastatin treatment was mainly mediated via biliary cholesterol secretion, whereas atorvastatin mainly stimulated cholesterol removal via the transintestinal cholesterol excretion pathway. Moreover, we show that plasma cholesterol precursor levels do not reflect cholesterol synthesis rates during statin treatment in mice. In conclusion, cholesterol synthesis is paradoxically increased upon statin treatment in mice. However, statins potently stimulate the excretion of cholesterol from the body, which sheds new light on possible mechanisms underlying the cholesterol-lowering effects of statins.
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Affiliation(s)
- Marleen Schonewille
- Department of Pediatrics University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan Freark de Boer
- Department of Pediatrics, Section Molecular Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Laura Mele
- Department of Pediatrics University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henk Wolters
- Department of Pediatrics University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Vincent W Bloks
- Department of Pediatrics University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Justina C Wolters
- Department of Pediatrics, Section Molecular Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan A Kuivenhoven
- Department of Pediatrics, Section Molecular Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Uwe J F Tietge
- Department of Pediatrics University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gemma Brufau
- Department of Pediatrics University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Albert K Groen
- Department of Pediatrics University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Department of Laboratory Medicine, Center for Liver, Digestive and Metabolic Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Amsterdam Diabetes Center, Department of Vascular Medicine, Academic Medical Center, The Netherlands
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Chater PI, Wilcox MD, Pearson JP, Brownlee IA. The impact of dietary fibres on the physiological processes governing small intestinal digestive processes. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.bcdf.2015.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Wang HH, Portincasa P, de Bari O, Liu KJ, Garruti G, Neuschwander-Tetri BA, Wang DQH. Prevention of cholesterol gallstones by inhibiting hepatic biosynthesis and intestinal absorption of cholesterol. Eur J Clin Invest 2013; 43:413-26. [PMID: 23419155 PMCID: PMC3996849 DOI: 10.1111/eci.12058] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 01/22/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cholesterol cholelithiasis is a multifactorial disease influenced by a complex interaction of genetic and environmental factors and represents a failure of biliary cholesterol homoeostasis in which the physical-chemical balance of cholesterol solubility in bile is disturbed. DESIGN The primary pathophysiologic event is persistent hepatic hypersecretion of biliary cholesterol, which has both hepatic and small intestinal components. The majority of the environmental factors are probably related to Western-type dietary habits, including excess cholesterol consumption. RESULTS Laparoscopic cholecystectomy, one of the most commonly performed surgical procedures in the United States, is nowadays a major treatment for gallstones. However, it is invasive and can cause surgical complications, and not all patients with symptomatic gallstones are candidates for surgery. The hydrophilic bile acid, ursodeoxycholic acid (UDCA), has been employed as first-line pharmacological therapy in a subgroup of symptomatic patients with small, radiolucent cholesterol gallstones. Long-term administration of UDCA can promote the dissolution of cholesterol gallstones. However, the optimal use of UDCA is not always achieved in clinical practice because of failure to titrate the dose adequately. CONCLUSIONS Therefore, the development of novel, effective and noninvasive therapies is crucial for reducing the costs of health care associated with gallstones. In this review, we summarize recent progress in investigating the inhibitory effects of ezetimibe and statins on intestinal absorption and hepatic biosynthesis of cholesterol, respectively, for the treatment of gallstones, as well as in elucidating their molecular mechanisms by which combination therapy could prevent this very common liver disease worldwide.
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Affiliation(s)
- Helen H Wang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
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Di Ciaula A, Wang DQH, Bonfrate L, Portincasa P. Current views on genetics and epigenetics of cholesterol gallstone disease. CHOLESTEROL 2013; 2013:298421. [PMID: 23691293 PMCID: PMC3649201 DOI: 10.1155/2013/298421] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 03/06/2013] [Accepted: 03/20/2013] [Indexed: 02/07/2023]
Abstract
Cholesterol gallstone disease, one of the commonest digestive diseases in western countries, is induced by an imbalance in cholesterol metabolism, which involves intestinal absorption, hepatic biosynthesis, and biliary output of cholesterol, and its conversion to bile acids. Several components of the metabolic syndrome (e.g., obesity, type 2 diabetes, dyslipidemia, and hyperinsulinemia) are also well-known risk factors for gallstones, suggesting the existence of interplay between common pathophysiological pathways influenced by insulin resistance, genetic, epigenetic, and environmental factors. Cholesterol gallstones may be enhanced, at least in part, by the abnormal expression of a set of the genes that affect cholesterol homeostasis and lead to insulin resistance. Additionally, epigenetic mechanisms (mainly DNA methylation, histone acetylation/deacetylation, and noncoding microRNAs) may modify gene expression in the absence of an altered DNA sequence, in response to different lithogenic environmental stimuli, such as diet, lifestyle, pollutants, also occurring in utero before birth. In this review, we will comment on various steps of the pathogenesis of cholesterol gallstones and interaction between environmental and genetic factors. The epigenomic approach may offer new options for therapy of gallstones and better possibilities for primary prevention in subjects at risk.
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Affiliation(s)
- Agostino Di Ciaula
- 1Division of Internal Medicine Hospital of Bisceglie, 76011 Bisceglie, Italy
| | - David Q.-H. Wang
- 2Saint Louis University School of Medicine, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Edward Doisy Research Center, St. Louis, MO 63104, USA
| | - Leonilde Bonfrate
- 3Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University “Aldo Moro“ of Bari Medical School, 70124 Bari, Italy
| | - Piero Portincasa
- 3Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University “Aldo Moro“ of Bari Medical School, 70124 Bari, Italy
- 4European Society for Clinical Investigation (ESCI), 3584 CJ Utrecht, The Netherlands
- *Piero Portincasa:
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Chiu HF, Chen CC, Kuo HW, Lee IM, Wu TN, Yang CY. Statin use and the risk of gallstone disease: a population-based case-control study. Expert Opin Drug Saf 2012; 11:369-74. [PMID: 22243480 DOI: 10.1517/14740338.2012.653560] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether the use of statins was associated with a decreased risk of gallstone disease. METHODS We conducted a population-based case-control study in Taiwan. Cases consisted of all patients who were aged 50 years and older and had a first-time diagnosis of gallstone disease or cholecystectomy for the period between 2005 and 2009. The controls were matched to cases by age, sex and index date. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by using multiple logistic regression. RESULTS We examined 1014 gallstone disease cases and 1014 controls. The unadjusted ORs for any statin prescription was 1.06 (95% CI 0.86 to 1.29), and the adjusted OR was 1.14 (95% CI 0.90 to 1.43). Compared with no use of statins, the adjusted ORs were 1.05 (95% CI 0.72 to 1.54) for the group having been prescribed statins with cumulative defined daily doses (DDDs) below 41.53, 1.12 (95% CI 0.84 to 1.50) for the group with cumulative dose between 41.54 and 334.81 DDD, and 1.30 (95% CI 0.86 to 1.95) for the group with cumulative statin use of 334.81 DDDs or more. CONCLUSIONS This study does not provide support for a beneficial association between usage of statin and gallstone disease.
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Affiliation(s)
- Hui-Fen Chiu
- Kaohsiung Medical University, Institute of Pharmacology, College of Medicine, Kaohsiung, Taiwan
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Di Ciaula A, Wang DQH, Wang HH, Bonfrate L, Portincasa P. Targets for current pharmacologic therapy in cholesterol gallstone disease. Gastroenterol Clin North Am 2010; 39:245-64, viii-ix. [PMID: 20478485 PMCID: PMC2915454 DOI: 10.1016/j.gtc.2010.02.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Gallstone disease is a frequent condition throughout the world and, cholesterol stones are the most frequent form in Western countries. The standard treatment of symptomatic gallstone subjects is laparoscopic cholecystectomy. The selection of patients amenable for nonsurgical, medical therapy is of key importance; a careful analysis should consider the natural history of the disease and the overall costs of therapy. Only patients with mild symptoms and small, uncalcified cholesterol gallstones in a functioning gallbladder with a patent cystic duct are considered for oral litholysis by hydrophilic ursodeoxycholic acid, in the hope of achieving cholesterol desaturation of bile and progressive stone dissolution. Recent studies have raised the possibility that cholesterol-lowering agents that inhibit hepatic cholesterol synthesis (statins) or intestinal cholesterol absorption (ezetimibe), or drugs acting on specific nuclear receptors involved in cholesterol and bile acid homeostasis, may offer, alone or in combination, additional medical therapeutic tools for treating cholesterol gallstones. Recent perspectives on medical treatment of cholesterol gallstone disease are discussed in this article.
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Affiliation(s)
- Agostino Di Ciaula
- Division of Internal Medicine, Hospital of Bisceglie, via Bovio 279 - 70052 - Bisceglie (Bari), Italy, +39-80-3363271, +39-80-3363232 (fax)
| | - David Q.-H. Wang
- Liver Center and Gastroenterology Division, Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School and Harvard Digestive Diseases Center, 330 Brookline Avenue, DA 601, Boston, MA 02215, (617) 667-0561, (617) 975-5071 (fax)
| | - Helen H. Wang
- Department of Medicine, Liver Center and Gastroenterology Division, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, DA 601, Boston, MA 02215, (617) 667-5156, (617) 975-5071 (fax)
| | - Leonilde Bonfrate
- Clinica Medica “A. Murri”, Department of Internal and Public Medicine, University of Bari Medical School, Piazza Giulio Cesare 11, Policlinico, 70124 Bari, Italy. +39-80-5478227, +39-80-5478232 (fax)
| | - Piero Portincasa
- Clinica Medica “A. Murri”, Department of Internal Medicine and Public Medicine, University Medical School, Bari, Italy
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Catalioto RM, Triolo A, Giuliani S, Altamura M, Evangelista S, Maggi CA. Increased paracellular absorption by bile salts and P-glycoprotein stimulated efflux of otilonium bromide in Caco-2 cells monolayers as a model of intestinal barrier. J Pharm Sci 2008; 97:4087-100. [PMID: 18200532 DOI: 10.1002/jps.21240] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The present study investigates the intestinal permeability of otilonium bromide, a spasmolytic drug used to treat irritable bowel syndrome, across Caco-2 cell monolayers. The amount of otilonium bromide transported was determined by high-performance liquid chromatography-mass spectrometry. Epithelial barrier integrity was estimated by measuring transepithelial electrical resistance and the transport of reference compounds, P-glycoprotein activity by measuring rhodamine 123 efflux. Results showed that the apparent permeability of otilonium bromide was comparable to that of our zero permeability marker, inulin, in the apical-to-basal direction and similar to that of rhodamine 123 in the basal-to-apical direction. The P-glycoprotein substrate, verapamil, prevented otilonium bromide efflux and, conversely, otilonium bromide inhibited P-glycoprotein activity. Bile salts induced a transient opening of tight junctions, as measured by selective increase of paracellular transport, and significantly enhanced the absorption of otilonium bromide. In turn otilonium bromide potentiates the effect of bile salts on tight junctions without modifying their critical micellar concentration or altering cell viability. In conclusion, otilonium bromide is a paracellularly transported drug whose absorption, in amounts sufficient to exert a spasmolytic effect, is favoured by bile salts. P-glycoprotein, by stimulating efflux, contributes to remove excess compound, restraining its distribution and site of action to the intestinal wall.
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Affiliation(s)
- Rose-Marie Catalioto
- Pharmacology Department, Menarini Ricerche SpA, Via Rismondo 12A, 50131 Florence, Italy.
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Thelen KM, Lütjohann D, Vesalainen R, Janatuinen T, Knuuti J, von Bergmann K, Lehtimäki T, Laaksonen R. Effect of pravastatin on plasma sterols and oxysterols in men. Eur J Clin Pharmacol 2005; 62:9-14. [PMID: 16385401 DOI: 10.1007/s00228-005-0068-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2005] [Accepted: 11/07/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The HMG-CoA reductase inhibitors, or statins, are well established in the prevention and treatment of coronary artery disease, mainly by lowering low-density lipoprotein (LDL) cholesterol levels. These compounds are structurally similar, but differ in their lipophilicity. Several studies have indicated a link between cholesterol and Alzheimer's disease (AD), and there is also epidemiological evidence that statin treatment may decrease the prevalence of dementias. In the present study we wanted to investigate whether pravastatin treatment affects brain cholesterol metabolism. METHODS A post hoc analysis was performed with plasma material from a clinical trial where 51 healthy men (35+/-4 years) were randomly assigned to receive either pravastatin (40 mg/day) or placebo for 6 months. Cholesterol, its precursor lathosterol, its brain-specific metabolite 24(S)-hydroxycholesterol (24S-OH-chol) and 27-hydroxycholesterol (27-OH-chol) were determined in plasma samples before and after treatment by using gas-liquid chromatography (GC)-flame ionization detection (GC-FID) and GC mass spectrometry (GC-MS). RESULTS Besides reducing total cholesterol (-20%, P<0.001) and LDL cholesterol (LDL-C; -33%, P<0.001) concentrations, pravastatin treatment resulted in a decrease of the ratio of lathosterol to cholesterol, a surrogate marker of endogenous cholesterol synthesis, by 20% (P<0.05). Absolute concentrations of 24S-OH-chol were not altered, but its ratio to cholesterol slightly increased by 15% (P<0.05). 27-OH-chol concentrations as well as its ratio to cholesterol were both significantly altered due to pravastatin treatment (-7% and +14%, P<0.05 for both, respectively). CONCLUSIONS The treatment with pravastatin 40 mg once a day for 6 months does not affect brain cholesterol metabolism as judged by plasma concentrations of 24(S)-hydroxycholesterol.
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Affiliation(s)
- Karin M Thelen
- Department of Clinical Pharmacology, University of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany, and Laboratory of Atherosclerosis Genetics, Department of Clinical Chemistry, University Hospital of Tampere, Finland
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Delsing DJM, Post SM, Groenendijk M, Solaas K, van der Boom H, van Duyvenvoorde W, de Wit ECM, Bloks VW, Kuipers F, Havekes LM, Princen HMG. Rosuvastatin Reduces Plasma Lipids by Inhibiting VLDL Production and Enhancing Hepatobiliary Lipid Excretion in ApoE*3-Leiden Mice. J Cardiovasc Pharmacol 2005; 45:53-60. [PMID: 15613980 DOI: 10.1097/00005344-200501000-00010] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The present study was designed to investigate the lipid-lowering properties and mechanisms of action of a new HMG-CoA reductase inhibitor, rosuvastatin, in female ApoE*3-Leiden transgenic mice. Mice received a high fat/cholesterol (HFC) diet containing either rosuvastatin (0 [control], 0.00125%, 0.0025%, or 0.005% [w/w]) or 0.05% (w/w) lovastatin. The highest dose of rosuvastatin reduced plasma cholesterol and triglyceride levels by 39% and 42%, respectively, compared with the HFC control. Lovastatin had no effect on plasma cholesterol and triglyceride levels. In ApoE*3-Leiden mice on a chow diet, rosuvastatin (0.005% [w/w]) decreased plasma cholesterol levels by 35% without having an effect on triglyceride levels. On a chow diet, expression of genes involved in cholesterol biosynthesis and uptake in the liver was increased by rosuvastatin. Further mechanistic studies in HFC-fed mice showed that rosuvastatin treatment resulted in decreased hepatic VLDL-triglyceride and VLDL-apolipoprotein B production. VLDL lipid composition remained unchanged, indicating a reduction in the number of VLDL particles secreted. Lipolytic activity and expression of genes involved in cholesterol and triglyceride synthesis and beta-oxidation of fatty acids in the liver were not affected by rosuvastatin treatment, and hepatic lipid content did not change. However, activity of hepatic diacylglycerol acyltransferase was significantly decreased by 25% after rosuvastatin treatment. Moreover, biliary excretion of cholesterol, phospholipids, and bile acids was increased during treatment. The results indicate that rosuvastatin treatment in ApoE*3-Leiden mice on a HFC diet leads to redistribution of cholesterol and triglycerides in the body, both by reduced hepatic VLDL production and triglyceride synthesis and by enhanced hepatobiliary removal of cholesterol, bile acids, and phospholipids, resulting in substantial reductions in plasma cholesterol and triglyceride levels.
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Rabine J, Jones MP. Successful use of an HMG-CoA reductase inhibitor as adjunctive therapy in the management of refractory bile leak complicating laparoscopic cholecystectomy. Am J Gastroenterol 1998; 93:2602-3. [PMID: 9860442 DOI: 10.1111/j.1572-0241.1998.00736.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- J Rabine
- Division of Gastroenterology, University of Cincinnati, Ohio 45267-0595, USA
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12
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Duane WC. Measurement of bile acid synthesis by three different methods in hypertriglyceridemic and control subjects. J Lipid Res 1997. [DOI: 10.1016/s0022-2275(20)37287-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Hahn C, von Bergmann K. Relationship between the serum concentration of 7 alpha-hydroxycholesterol and fecal bile acid excretion in humans. Scand J Gastroenterol 1996; 31:804-8. [PMID: 8858751 DOI: 10.3109/00365529609010356] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Serum levels of 7 alpha-hydroxycholesterol have been shown to reflect the activity of cholesterol 7 alpha-hydroxylase, the key enzyme of bite acid synthesis in the liver, but a comparison with direct measurements of bile acid synthesis rates has never been performed. METHODS 7 alpha-Hydroxycholesterol was measured by gas-liquid chromatography/mass spectrometry and bile acid synthesis by the fecal balance method in 35 subjects. RESULTS A significant correlation was found between 7 alpha-hydroxycholesterol concentration in serum and bile acid synthesis (r = 0.863, p < 0.001). Serum levels of 7 alpha-hydroxycholesterol in 20 patients treated with a 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor did not differ from levels obtained in healthy volunteers (78 +/- 7 ng/ml versus 63 +/- 5 ng/ml; NS). Treatment with fenofibrate reduced 7 alpha-hydroxycholesterol concentrations in six patients from 107 +/- 47 ng/ml to 61 +/- 12 ng/ml (p < 0.05). CONCLUSIONS We conclude that the concentration of 7 alpha-hydroxycholesterol in serum is an indicator of bile acid synthesis and that serum levels of 7 alpha-hydroxycholesterol are not affected in patients treated with HMG-CoA reductase inhibitors but are affected in those treated with fenofibrate.
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Affiliation(s)
- C Hahn
- Dept. of Clinical Pharmacology, University of Bonn, Germany
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