Kyselina ursodeoxycholová jakožto sekundární žlučová kyselina je po řadu desetiletí úspěšně využívána u patologických stavů postihujících žlučové cesty. Kromě disoluce žlučových kamenů se uplatňuje u chronických onemocnění jater či u reaktivní gastritidy navozené refluxem žluči. V následujícím textu je pojednán její terapeutický potenciál na pozadí pleiotropního mechanismu účinku.
Ursodeoxycholic acid, as a secondary bile acid, has been used successfully for many decades in pathological conditions affecting the bile ducts. In addition to the dissolution of gallstones, it is used in chronic liver diseases or in reactive gastritis induced by bile reflux. In the following text, its therapeutic potential against the background of its pleiotropic mechanism of action is discussed.
- MeSH
- biliární cirhóza farmakoterapie MeSH
- cholagoga a choleretika aplikace a dávkování farmakologie terapeutické užití MeSH
- cystická fibróza farmakoterapie MeSH
- gastritida farmakoterapie MeSH
- gastrointestinální nemoci * farmakoterapie MeSH
- kyselina ursodeoxycholová * aplikace a dávkování farmakologie terapeutické užití MeSH
- lidé MeSH
- nealkoholová steatóza jater farmakoterapie MeSH
- sklerozující cholangitida farmakoterapie MeSH
- Check Tag
- lidé MeSH
The treatment of hypercholesterolemia with bile acid (BA) sequestrants results in upregulation of BA synthesis through the classical pathway initiated by cholesterol 7alpha-hydroxylase (CYP7A1). To characterize the detailed dynamics of serum lipid and BA concentrations and the BA synthesis rate in response to treatment with BA sequestrants and to determine whether the -203A/C promoter polymorphism of the CYP7A1 encoding gene (CYP7A1) affects such a response, this pilot study was carried out in healthy men (8 homozygous for the -203A allele and 8 homozygous for the -203C allele of CYP7A1). The subjects were treated for 28 days with colesevelam and blood was drawn for analysis before and on days 1, 3, 7, 14 and 28 of treatment. The response of lipids, BA, fibroblast growth factor-19 (FGF19) and 7alpha-hydroxy-4-cholesten-3-one (C4) to colesevelam did not differ between carriers of -203A and -203C alleles; their data were then aggregated for further analysis. Colesevelam treatment caused immediate suppression of FGF19 concentration and a fivefold increase in CYP7A1 activity, as assessed from C4 concentration, followed by a 17 % decrease in LDL-cholesterol. Although total plasma BA concentrations were not affected, the ratio of cholic acid/total BA rose from 0.25+/-0.10 to 0.44+/-0.16 during treatment at the expense of decreases in chenodeoxycholic and deoxycholic acid.
- MeSH
- alely MeSH
- cholagoga a choleretika farmakologie MeSH
- cholestenony krev MeSH
- cholesterol-7-alfa-hydroxylasa genetika metabolismus MeSH
- dospělí MeSH
- fibroblastové růstové faktory metabolismus MeSH
- genotyp MeSH
- hormony štítné žlázy metabolismus MeSH
- kolesevelam farmakologie MeSH
- krevní glukóza metabolismus MeSH
- LDL-cholesterol krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- metabolismus lipidů účinky léků MeSH
- pilotní projekty MeSH
- polymorfismus genetický MeSH
- zdraví dobrovolníci pro lékařské studie MeSH
- žlučové kyseliny a soli metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Boldine, the major alkaloid from the Chilean Boldo tree, is used in traditional medicine to support bile production, but evidence to support this function is controversial. We analyzed the choleretic potential of boldine, including its molecular background. The acute- and long-term effects of boldine were evaluated in rats either during intravenous infusion or after 28-day oral treatment. Infusion of boldine instantly increased the bile flow 1.4-fold in healthy rats as well as in animals with Mrp2 deficiency or ethinylestradiol induced cholestasis. This effect was not associated with a corresponding increase in bile acid or glutathione biliary excretion, indicating that the effect is not related to stimulation of either bile acid dependent or independent mechanisms of bile formation and points to the osmotic activity of boldine itself. We subsequently analyzed bile production under conditions of changing biliary excretion of boldine after bolus intravenous administration and found strong correlations between both parameters. HPLC analysis showed that bile concentrations of boldine above 10 μM were required for induction of choleresis. Importantly, long-term pretreatment, when the bile collection study was performed 24-h after the last administration of boldine, also accelerated bile formation despite undetectable levels of the compound in bile. The effect paralleled upregulation of the Bsep transporter and increased biliary clearance of its substrates, bile acids. We consequently confirmed the ability of boldine to stimulate the Bsep transcriptional regulator, FXR receptor. In conclusion, our study clarified the mechanisms and circumstances surrounding the choleretic activity of boldine.
- MeSH
- ABC transportéry nedostatek genetika metabolismus MeSH
- aplikace orální MeSH
- aporfiny aplikace a dávkování metabolismus farmakologie MeSH
- buňky Hep G2 MeSH
- buňky MDCK MeSH
- cholagoga a choleretika aplikace a dávkování metabolismus farmakologie MeSH
- ethinylestradiol farmakologie MeSH
- genetická transkripce účinky léků MeSH
- glutathion metabolismus MeSH
- hepatobiliární exkrece MeSH
- intravenózní infuze MeSH
- játra účinky léků metabolismus MeSH
- kinetika MeSH
- lidé MeSH
- osmóza MeSH
- potkani inbrední LEW MeSH
- potkani transgenní MeSH
- potkani Wistar MeSH
- proteiny spojené s mnohočetnou rezistencí k lékům genetika metabolismus MeSH
- psi MeSH
- receptory cytoplazmatické a nukleární agonisté genetika metabolismus MeSH
- signální transdukce účinky léků MeSH
- transfekce MeSH
- upregulace MeSH
- žluč metabolismus MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- psi MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
The consumption of lipids and simple sugars induces an inflammatory response whose exact molecular trigger remains elusive. The aims of the present study were to investigate (1) whether inflammation induced by a single high-energy, high-fat meal (HFM) is associated with endoplasmic reticulum stress (ERS) in peripheral blood mononuclear cells (PBMC) and (2) whether these inflammatory and ERS responses could be prevented by the chemical chaperone ursodeoxycholic acid (UDCA). A total of ten healthy lean men were recruited to a randomised, blind, cross-over trial. Subjects were given two doses of placebo (lactose) or UDCA before the consumption of a HFM (6151 kJ; 47·4 % lipids). Blood was collected at baseline and 4 h after the HFM challenge. Cell populations and their activation were analysed using flow cytometry, and plasma levels of inflammatory cytokines were assessed by ELISA and Luminex technology. Gene expression levels of inflammatory and ERS markers were analysed in CD14⁺ and CD14⁻ PBMC using quantitative RT-PCR. The HFM induced an increase in the mRNA expression levels of pro-inflammatory cytokines (IL-1β, 2·1-fold; IL-8, 2·4-fold; TNF-α, 1·4-fold; monocyte chemoattractant protein 1, 2·1-fold) and a decrease in the expression levels of miR181 (0·8-fold) in CD14⁺ monocytes. The HFM challenge did not up-regulate the expression of ERS markers (XBP1, HSPA5, EDEM1, DNAJC3 and ATF4) in either CD14⁺ or CD14⁻ cell populations, except for ATF3 (2·3-fold). The administration of UDCA before the consumption of the HFM did not alter the HFM-induced change in the expression levels of ERS or inflammatory markers. In conclusion, HFM-induced inflammation detectable on the level of gene expression in PBMC was not associated with the concomitant increase in the expression levels of ERS markers and could not be prevented by UDCA.
- MeSH
- adaptivní imunita * účinky léků MeSH
- antiflogistika farmakologie MeSH
- antigeny CD14 krev metabolismus MeSH
- biologické markery krev metabolismus MeSH
- cholagoga a choleretika farmakologie MeSH
- cytokiny krev genetika metabolismus MeSH
- dieta s vysokým obsahem tuků škodlivé účinky MeSH
- dospělí MeSH
- energetický příjem MeSH
- hyperfagie krev imunologie metabolismus MeSH
- jídla * MeSH
- klinické křížové studie MeSH
- kyselina ursodeoxycholová farmakologie MeSH
- leukocyty mononukleární účinky léků imunologie metabolismus MeSH
- lidé MeSH
- mikro RNA metabolismus MeSH
- postprandiální období MeSH
- přirozená imunita * účinky léků MeSH
- regulace genové exprese účinky léků MeSH
- stres endoplazmatického retikula * účinky léků MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: Ursodeoxycholic acid (UDCA) is used to treat primary biliary cirrhosis, intrahepatic cholestasis, and other cholestatic conditions. Although much has been learned about the molecular basis of the disease pathophysiology, our understanding of the effects of UDCA remains unclear. Possibly underlying its cytoprotective, anti-apoptotic, anti-oxidative effects, UDCA was reported to regulate the expression of TNFα and other inflammatory cytokines. However, it is not known if this effect involves also modulation of ADAM family of metalloproteinases, which are responsible for release of ectodomains of inflammatory cytokines from the cell surface. We hypothesized that UDCA modulates ADAM17 activity, resulting in amelioration of cholestasis in a murine model of bile duct ligation (BDL). METHODS: The effect of UDCA on ADAM17 activity was studied using the human liver hepatocellular carcinoma cell line HepG2. Untransfected cells or cells ectopically expressing human ADAM17 were cultured with or without UDCA and further activated using phorbol-12-myristate-13-acetate (PMA). The expression and release of ADAM17 substrates, TNFα, TGFα, and c-Met receptor (or its soluble form, sMet) were evaluated using ELISA and quantitative real-time (qRT) PCR. Immunoblotting analyses were conducted to evaluate expression and activation of ADAM17 as well as the level of ERK1/2 phosphorylation after UDCA treatment. The regulation of tissue inhibitor of metalloproteinases-1 (TIMP-1) by UDCA was studied using zymography and qRT-PCR. A mouse model of acute cholestasis was induced by common BDL technique, during which mice received daily orogastric gavage with either UDCA or vehicle only. Liver injury was quantified using alkaline phosphatase (ALP), relative liver weight, and confirmed by histological analysis. ADAM17 substrates in sera were assessed using a bead multiplex assay. RESULTS: UDCA decreases amount of shed TNFα, TGFα, and sMet in cell culture media and the phosphorylation of ERK1/2. These effects are mediated by the reduction of ADAM17 activity in PMA stimulated cells although the expression ADAM17 is not affected. UDCA reduced the level of the mature form of ADAM17. Moreover, UDCA regulates the expression of TIMP-1 and gelatinases activity in PMA stimulated cells. A BDL-induced acute cholangitis model was characterized by increased relative liver weight, serum levels of ALP, sMet, and loss of intracellular glycogen. UDCA administration significantly decreased ALP and sMet levels, and reduced relative liver weight. Furthermore, hepatocytes of UDCA-treated animals retained their metabolic activity as evidenced by the amount of glycogen storage. CONCLUSIONS: The beneficial effect of UDCA appears to be mediated in part by the inhibition of ADAM17 activation and, thus, the release of TNFα, a strong pro-inflammatory factor. The release of other ADAM17 substrates, TGFα and sMet, are also regulated this way, pointing to a general impact on the release of ADAM17 substrates, which are pivotal for liver regeneration and function. In parallel, UDCA upregulates TIMP-1 that in turn inhibits matrix metalloproteinases, which destroy the hepatic ECM in diseased liver. This control of extracellular matrix turnover represents an additional beneficial path of UDCA treatment.
- MeSH
- buňky Hep G2 MeSH
- cholagoga a choleretika farmakologie MeSH
- cholestáza MeSH
- hepatocyty účinky léků MeSH
- játra účinky léků MeSH
- kyselina ursodeoxycholová farmakologie MeSH
- lidé MeSH
- ligace MeSH
- MAP kinasový signální systém účinky léků MeSH
- myši MeSH
- proteiny ADAM účinky léků MeSH
- protoonkogenní proteiny c-met účinky léků metabolismus MeSH
- TNF-alfa účinky léků metabolismus MeSH
- transformující růstový faktor alfa účinky léků metabolismus MeSH
- žlučové cesty chirurgie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
15. akt. Aufl. 217 s. : il., tab. ; 21 cm
- MeSH
- biliární cirhóza farmakoterapie MeSH
- cholagoga a choleretika aplikace a dávkování farmakokinetika farmakologie škodlivé účinky terapeutické užití MeSH
- gastroezofageální reflux farmakoterapie MeSH
- kyselina deoxycholová analogy a deriváty aplikace a dávkování farmakokinetika farmakologie škodlivé účinky terapeutické užití MeSH
- žlučové kameny farmakoterapie MeSH
- Publikační typ
- monografie MeSH
- Konspekt
- Farmacie. Farmakologie
- NLK Obory
- gastroenterologie
- hepatologie
- farmacie a farmakologie
- farmakoterapie