Departamento de Gastroenterología, Escuela de Medicina. Pontificia Universidad Católica de Chile. Santiago, Chile.
Departamento de Ciencias Químicas y Biológicas, Facultad de Salud, Universidad Bernardo O'Higgins, Santiago. Chile.
Ann Hepatol. 2017 Nov;16(Suppl. 1: s3-105.):s53-s57. doi: 10.5604/01.3001.0010.5497.
Bile acids (BA) are key molecules in generating bile flow, which is an essential function of the liver. In the last decades there have been great advances in the understanding of the role of a number of specific transport proteins present at the sinusoidal and canalicular membrane domains of hepatocytes and cholangiocytes in generating and maintaining bile flow. Also, a clearer understanding on how BA regulate their own synthesis and the expression and/or function of transporters has been reached. This new knowledge has helped to better delineate the pathophysiology of cholestasis and the adaptive responses of hepatocytes to cholestatic liver injury as well as of the mechanisms of injury of biliary epithelia. In this context, therapeutic approaches including new hydrophilic BA such as the conjugation-resistant nor- ursodeoxycholic acid, nuclear receptors (FXR, PPAR-alpha) agonists, FGF19 analogues, inhibitors of the apical sodium-dependent bile acid transporter [ASBT] and modulators of the inflammatory cascade triggered by BAs are being studied as novel treatments of cholestasis. In the present review we summarize recent experimental and clinical data on the role of BAs in cholestasis and its treatment.
胆汁酸（BA）是产生胆汁流的关键分子，而胆汁流是肝脏的基本功能之一。在过去的几十年中，人们对存在于肝细胞和胆管细胞的窦状膜和胆小管膜域的一些特定转运蛋白在产生和维持胆汁流方面的作用有了更深入的了解。此外，人们对 BA 如何调节自身合成以及转运体的表达和/或功能也有了更清晰的认识。这些新知识有助于更好地描绘出胆汁淤积症的病理生理学以及肝细胞对胆汁淤积性肝损伤的适应性反应，还有胆管上皮细胞损伤的机制。在这种情况下，人们正在研究包括新的亲水性 BA（如结合抗性的熊去氧胆酸）、核受体（FXR、PPAR-α）激动剂、FGF19 类似物、顶端钠依赖性胆汁酸转运蛋白（ASBT）抑制剂和 BA 触发的炎症级联反应调节剂等治疗方法，将其作为胆汁淤积症的新型治疗方法。在本篇综述中，我们总结了关于 BA 在胆汁淤积症及其治疗中的作用的最新实验和临床数据。
