Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Road, Pudong New District, Shanghai, 200120, China.
Metabolomics. 2022 Jul 1;18(7):46. doi: 10.1007/s11306-022-01906-7.
Recurrence after the endoscopic treatment of common bile duct stones (CBDS) is related to bile metabolism and bile compositions. Ursodeoxycholic acid (UDCA) has been proved effective in reducing the recurrence of CBDS. However, the detailed effects of UDCA on bile metabolism are still not extensively explored.
This study aimed to analyze the role of UDCA in patients with choledocholithiasis (CDC) from the perspective of biochemistry and metabolomics.
A total of 89 patients with CDC who underwent endoscopic retrograde cholangiopancreatography were prospectively examined and randomly assigned to control and UDCA groups. The biochemical detections (cholesterol, bilirubin, and so on) were performed on the collected bile. Moreover, the metabolomics analysis was conducted based on bile from 20 patients in the UDCA group.
The bile levels of cholesterol and endotoxins significantly decreased after UDCA treatment. Regarding bile metabolomics, the levels of 25 metabolites changed significantly after UDCA treatment. The pathway enrichment analysis showed that the UDCA addition evoked a common response related to phenylalanine, tyrosine, and tryptophan biosynthesis; phenylalanine metabolism; arachidonic acid metabolism; and terpenoid backbone biosynthesis.
UDCA treatment within a short time interval (7 days) did not improve the circulating laboratory values in patients with CDC who had undergone endoscopy surgery. However, relevant decreases in the bile levels of cholesterol and endotoxin were observed. UDCA evoked a common response related to lipid metabolism and amino acid metabolism, which probably reduced the bile level of cholesterol, protected hepatocytes, and corrected the abnormality of lipid metabolism caused by CDC.
胆总管结石（CBDS）内镜治疗后的复发与胆汁代谢和胆汁成分有关。熊去氧胆酸（UDCA）已被证明可有效降低 CBDS 的复发率。然而，UDCA 对胆汁代谢的详细影响仍未得到广泛探讨。
本研究旨在从生化和代谢组学的角度分析 UDCA 在胆总管结石（CDC）患者中的作用。
前瞻性检查 89 例接受内镜逆行胰胆管造影术的 CDC 患者，并将其随机分为对照组和 UDCA 组。收集胆汁进行生化检测（胆固醇、胆红素等）。此外，对 UDCA 组 20 例患者的胆汁进行代谢组学分析。
UDCA 治疗后胆汁中胆固醇和内毒素水平显著降低。在胆汁代谢组学方面，25 种代谢物的水平在 UDCA 治疗后发生了显著变化。通路富集分析显示，UDCA 处理引起了与苯丙氨酸、酪氨酸和色氨酸生物合成、苯丙氨酸代谢、花生四烯酸代谢和萜类骨架生物合成相关的共同反应。
在短时间（7 天）内，UDCA 治疗并未改善接受内镜手术的 CDC 患者的循环实验室值。然而，观察到胆汁中胆固醇和内毒素水平的相关降低。UDCA 引起了与脂质代谢和氨基酸代谢相关的共同反应，这可能降低了胆固醇的胆汁水平，保护了肝细胞，并纠正了 CDC 引起的脂质代谢异常。
