On the enterohepatic circulation of bile acids in man. 1982

S Ewerth

1. Fasting concentrations of C, CD and D were determined in systemic and portal venous serum in gallstone patients and controls (patients with adenomyoma of the gallbladder) undergoing cholecystectomy. No differences were observed between the two groups either in systemic or portal serum concentrations of the bile acids or in their hepatic uptake. Ketonic bile acid concentrations amounted to 9% and 8% of the non-oxidized bile acids in the systemic and portal circulation, respectively. 2. Fasting systemic and portal venous serum concentrations of bile acids were measured in gallstone patients fed with C and CD prior to cholecystectomy. Treatment with CD increased the total portal inflow of bile acids by 60%, whereas C treatment did not alter this total inflow compared with controls. This difference may partly explain why hepatic bile is unsaturated during treatment with CD, but not with C. 3. The postprandial concentrations of bile acids were determined in the systemic and portal venous circulation in cholecystectomized patients. The systemic venous bile acid level reflected the portal venous level. The estimated hepatic uptake of the individual bile acids was highly efficient and could not be saturated during maximal physiological portal inflow to the liver. The existence of a lymphatic transport of bile acids, calculated to correspond to about 0.2% of the portal transport, was demonstrated in four patients undergoing renal transplantation. 4. Cholestyramine treatment was shown to reduce the plasma cholesterol level in patients with familial hypercholesterolaemia without lowering the fasting systemic level of total bile acids. Nor did this treatment reduce the fasting portal inflow of total bile acids. The total bile acid concentration in healthy volunteers during treatment showed a 40% reduction postprandially, but not in the fasting state, indicating that the effect of cholestyramine on hepatic cholesterol metabolism is the consequence of a reduced postprandial inflow of portal bile acids. The effects of the loss of the active site of bile acid absorption on the postprandial serum bile acid pattern were studied in patients with ileal resections. In general, the postprandial response of C was reduced whereas that of CD remained less affected.

UI MeSH Term Description Entries
D007413 Intestinal Mucosa Lining of the INTESTINES, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. In the SMALL INTESTINE, the mucosa is characterized by a series of folds and abundance of absorptive cells (ENTEROCYTES) with MICROVILLI. Intestinal Epithelium,Intestinal Glands,Epithelium, Intestinal,Gland, Intestinal,Glands, Intestinal,Intestinal Gland,Mucosa, Intestinal
D008099 Liver A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances. Livers
D002621 Chemistry A basic science concerned with the composition, structure, and properties of matter; and the reactions that occur between substances and the associated energy exchange.
D002769 Cholelithiasis Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS). Gallstone Disease,Cholelithiases,Gallstone Diseases
D002792 Cholestyramine Resin A strongly basic anion exchange resin whose main constituent is polystyrene trimethylbenzylammonium Cl(-) anion. Cholestyramine,Colestyramine,Colestyramin,Cuemid,MK-135,Quantalan,Questran,Cholestyramine Resins,Cholestyramines,Colestyramines,Colestyramins,Cuemids,MK 135,MK135,Quantalans,Questrans,Resin, Cholestyramine,Resins, Cholestyramine
D005502 Food Substances taken in by the body to provide nourishment. Foods
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001647 Bile Acids and Salts Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. Bile Acid,Bile Salt,Bile Salts,Bile Acids,Acid, Bile,Acids, Bile,Salt, Bile,Salts, Bile
D001659 Biliary Tract The BILE DUCTS and the GALLBLADDER. Biliary System,Biliary Tree,System, Biliary,Tract, Biliary,Tree, Biliary
D055598 Chemical Phenomena The composition, structure, conformation, and properties of atoms and molecules, and their reaction and interaction processes. Chemical Concepts,Chemical Processes,Physical Chemistry Concepts,Physical Chemistry Processes,Physicochemical Concepts,Physicochemical Phenomena,Physicochemical Processes,Chemical Phenomenon,Chemical Process,Physical Chemistry Phenomena,Physical Chemistry Process,Physicochemical Phenomenon,Physicochemical Process,Chemical Concept,Chemistry Process, Physical,Chemistry Processes, Physical,Concept, Chemical,Concept, Physical Chemistry,Concept, Physicochemical,Concepts, Chemical,Concepts, Physical Chemistry,Concepts, Physicochemical,Phenomena, Chemical,Phenomena, Physical Chemistry,Phenomena, Physicochemical,Phenomenon, Chemical,Phenomenon, Physicochemical,Physical Chemistry Concept,Physicochemical Concept,Process, Chemical,Process, Physical Chemistry,Process, Physicochemical,Processes, Chemical,Processes, Physical Chemistry,Processes, Physicochemical

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