Ahmed Monjur
Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Clin Exp Gastroenterol. 2022 Jul 20;15:105-120. doi: 10.2147/CEG.S360563. eCollection 2022.
Bile is a unique body fluid synthesized in our liver. Enterohepatic circulation preserves bile in our body through its efficient synthesis, transport, absorption, and reuptake. Bile is the main excretory route for bile salts, bilirubin, and potentially harmful exogenous lipophilic substances. The primary way of eliminating cholesterol is bile. Although bile has many organic and inorganic contents, bile acid is the most physiologically active component. Bile acids have a multitude of critical physiologic functions in our body. These include emulsification of dietary fat, absorption of fat and fat-soluble vitamins, maintaining glucose, lipid, and energy homeostasis, sustenance of intestinal epithelial integrity and epithelial cell proliferation, reducing inflammation in the intestine, and prevention of enteric infection due to its antimicrobial properties. But bile acids can be harmful in certain altered conditions like cholecystectomy, terminal ileal disease or resection, cholestasis, duodenogastric bile reflux, duodenogastroesophageal bile reflux, and bile acid diarrhea. Bile acids can have malignant potentials as well. There are also important diagnostic and therapeutic roles of bile acid and bile acid modulation.
胆汁是我们肝脏合成的一种独特体液。肠肝循环通过其高效的合成、运输、吸收和再摄取，将胆汁保留在我们体内。胆汁是胆盐、胆红素和潜在有害的外源性亲脂性物质的主要排泄途径。消除胆固醇的主要方式是通过胆汁。尽管胆汁含有许多有机和无机成分，但胆汁酸是最具生理活性的成分。胆汁酸在我们体内具有多种关键的生理功能。这些功能包括乳化膳食脂肪、吸收脂肪和脂溶性维生素、维持葡萄糖、脂质和能量稳态、维持肠上皮完整性和上皮细胞增殖、减轻肠道炎症以及因其抗菌特性预防肠道感染。但在某些改变的情况下，如胆囊切除术、终末回肠疾病或切除、胆汁淤积、十二指肠-胃胆汁反流、十二指肠-胃食管胆汁反流和胆汁酸腹泻，胆汁酸可能是有害的。胆汁酸也可能具有致癌潜能。胆汁酸及其调节在诊断和治疗方面也具有重要作用。
