On the kinetics of glycocholate uptake and excretion by the normal and diseased liver in man.

Serum concentrations of glycocholate and plasma disappearance curves of i.v. injected 14C-glycocholate were measured in 6 controls and 12 patients with liver disease. On the basis of these data, hepatic uptake and biliary excretion of serum glycocholate were calculated using a previously described 3-compartmental model. The results demonstrate that the hepatic uptake increases in correlation with the serum concentrations even if the biliary excretion decreases. As a consequence of reflux of glycocholate into the serum, increases also, indicating an increased bidirectional flux of bile acids in patients with elevated serum concentrations. These findings a) confirm that hepatic uptake and biliary excretion of glycocholate are independent transport mechanisms in man, b) indicate that hepatic uptake the more effective transport mechanism in the diseased liver, and c) suggest that liver uptake and reflux are different transport mechanisms. The possible pathophysiological importance of these findings is discussed.