Highlight report: New insights in liver physiology: Canalicular bile flux is diffusion dominated.

One of the central functions of the liver is excretion of bile into the intestine. Currently, bile excretion is explained by the osmotic model, according to which bile acids are excreted by hepatocytes into the bile canaliculi and since bile acids are osmotically active they draw water into the canalicular lumen. Bile canaliculi are closed at the central side. Therefore, bile was postulated to flow to the open side into the ducts. However, bile flow in canaliculi has never been measured because of the small canalicular diameter which does not allow analysis of flux by conventional methods. Recently, methods have been developed that allow flow analysis in bile canaliculi and ducts. Interestingly, no measurable directed flow was observed in the canaliculi. Instead, small molecules in bile canaliculi reached the larger bile ducts by diffusion. Only there measurable flow sets in. The pathophysiological implications of this novel observation are discussed.