Abstract
Bile acids are capable of disrupting the gastric and esophageal mucosal barriers and are known to differ in their ability to injure these mucosae. Two bile acids, chenodeoxycholic and its 7-B epimer, ursodeoxycholic, that are being used to dissolve gallbladder stones were evaluated for their damaging effects on experimental preparations of the esophageal (rabbit) and gastric (dog) mucosa. Damage was assessed by measuring indices of mucosal barrier function, including net acid flux, potential difference, and tissue resistance, before and after exposure to the taurine conjugates of these bile acids. In both the esophageal and gastric mucosa, tauroursodeoxycholic acid caused significantly less disruption of barrier function than taurochenodeoxycholic acid. These results demonstrate that minor differences in conjugated bile acid structure can cause major changes in the effects of bile acids on the upper gastrointestinal mucosa and that ursodeoxycholic acid may be the preferred bile acid for oral ingestion to dissolve gallbladder stones.
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References
Davenport HW: Destruction of the gastric mucosal barrier by detergents and urea. Gastroenterology 54:175–180, 1968
Black RB, Hole D, Rhodes J: Bile damage to the gastric mucosa: The influence of pH and bile acid concentration. Gastroenterology 61:178–184, 1971
Silen W, Forte JG: Effects of bile salts on amphibian gastric mucosa. Am J Physiol 228:637–644, 1975
Gadacz TR, Zuidema GD: Bile acid composition in patients with and without symptoms of postoperative reflux gastritis. Am J Surg 135:48–50, 1978
Ritchie WP, Shearburn, EW; Acute gastric ulcerogenesis is dependent on the concentration of bile salt. Surgery 80:98–105, 1976
Rhodes J, Barnado DE, Phillips SF, Rovelstad RA, Hofmann AF: Increased reflux of bile into the stomach in patients with gastric ulcer. Gastroenterology 57:241–252, 1969
Hamza K, DenBesten L: Bile salts producing stress ulcer during shock. Clin Res 19:393, 1971
Ritchie WP: Acute gastric mucosal damage induced by bile salts, acid, and ischemia. Gastroenterology 68:699–707, 1975
Chung RSK, Johnson GM, Den Besten L: Effect of sodium taurocholate and ethanol on hydrogen ion absorption in rabbit esophagus. Am J Dig Dis 11:582–588, 1977
Harmon JW, Johnson LF, Maydonvitch CL. Effect of acid and bile salts on the rabbit esophageal mucosa. Dig Dis Sci 16:65–72, 1981
Lillemoe KD, Johnson LF, Harmon JW: Role of the components of the gastroduodenal contents in experimental acid esophagitis. Surgery 92:276–284, 1982
Safaie-Shirazi S, DenBesten L, Zike WL: Effect of bile salts on the ionic permeability of the esophageal mucosa and their role in the production of esophagitis. Gastroenterology 68:728–733, 1975
Harmon JW, Doong T, Gadacz TR: Bile acids are not equally damaging to gastric mucosa. Surgery 84:79–86, 1978
Harmon JW, Lewis CD, Gadacz TR: Bile salt composition and concentration are determinants of canine gastric mucosal injury. Surgery 89:348–354, 1981
Ritchie WP, Fleger TS: Differing ulcerogenic potential of dihydroxy and trihydroxy bile acids in canine gastric mucosa. Surgery 89:342–347, 1981
Harmon JW, Woods M, Gurll NJ: Different mechanisms of hydrogen ion removal in stomach and duodenum. Am J Physiol 235:E692–E698, 1978
Kivilaakso E, Fromm D, Silen W: Effect of bile salts and related compounds on isolated esophageal mucosa. Surgery 87:280–285, 1980
Powell DW, Orlando RC, Carney CN: Acid injury to the esophageal epithelium.In Basic Mechanisms of Gastrointestinal Mucosal Cell Injury and Protection. JW Harmon (ed). Baltimore, Williams and Wilkins, 1981, pp 155–177
Kidder GW, Lillemoe KD, Harmon JW, Maydonovitch CL, Bunte RM, Johnson LF:In vivo measurement of transepithelial electrical resistance in the rabbit esophagus: A new parameter of esophageal mucosal injury. Gastroenterology 82:1100, 1982
Duane WC, Wiegand DM: Mechanism by which bile salt disrupts the gastric mucosal barrier in the dog. J Clin Invest 66:1044–1049, 1980
Armstrong MJ, Carey MC: The hydrophobic hydrophilic balance of bile salts. Inverse correlation between reversephase high performance liquid chromatographic mobilities and micellar cholesterol-solubilizing capacities. J Lipid Res 23:70–80, 1982
Igimi H, Carey MC: Cholesterol gallstone dissolution in bile: Dissolution kinetics of crystalline (anhydrate and monohydrate) cholesterol with chenodeoxycholate, ursodeoxycholate, and their glycine and taurine conjugates. J Lipid Res 22:254–270, 1981
Danzinger, RG, Hofmann AF, Schoenfield LJ, Thistle JL: Dissolution of cholesterol gallstones by chenodeoxycholic acid. N Engl J Med 286:1–8, 1972
Barbara L, Roda E, Roda A, Sama C, Festi D, Mazzella G, Aldini R: The medical treatment of cholesterol gallstones: Experience with chenodeoxycholic acid. Digestion 14:209–219, 1976
Nakagawa S, Makino I, Ishizaki T, Dohi I: Dissolution of cholesterol gallstones by ursodeoxycholic acid. Lancet 2:367–369, 1977
Maton PN, Murphy GM, Dowling RH: Ursodeoxycholic acid treatment of gallstones. Lancet 2:1297–1301, 1977
Salen G, Colalillo A, Verga D, Bagan E, Tint G, Shefer S: Effect of high and low doses of ursodeoxycholic acid on gallstone dissolution in humans. Gastroenterology 78:1412–1418, 1980
Stol DW, Murphy GM, Collis JL: Duodeno-gastric reflux and acid secretion in patients with symptomatic hiatal hernia. Scand J Gastroenterol 9:97–101, 1974
Kaye MD, Showalter JP: Pyloric incompetence in patients with symptomatic gastroesophageal reflux. J Lab Clin Med 83:198–206, 1974
Stefaniwsky AB, Tint GS, Speck J, Salen G: Ursodeoxycholic acid (UDCA) reduces pain, nausea, and vomiting in patients with bile acid reflux gastritis. Gastroenterology 82:1188, 1982
Chadwick VS, Gaginella TS, Degongie JC, Phillips SF, Hofmann AF: Different effects of chenodeoxycholic and ursodeoxycholic acids on colonic secretion, permeability, and morphology. Gastroenterology 71:900, 1976
Caspary WF, Meyne K: Effects of chenodeoxy and ursodeoxycholic acid and absorption, secretion, and permeability in rat colon and small intestine. Digestion 20:168–174, 1980
Keane RM, Birmingham WJ, Gadacz TR, Winchurch RA, Munster AM: Differential supression of human lymphocyte function by bile acids. Surg Forum 32:69–71, 1981
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Supported in part by NIAMD AM-21835-02 and the Veteran's Administration.
Supported in part by NIH Research Grant AM 21506.
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Lillemoe, K.D., Kidder, G.W., Harmon, J.W. et al. Tauroursodeoxycholic acid is less damaging than taurochenodeoxycholic acid to the gastric and esophageal mucosa. Digest Dis Sci 28, 359–364 (1983). https://doi.org/10.1007/BF01324955
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DOI: https://doi.org/10.1007/BF01324955