Document Detail

Chenotherapy for gallstone dissolution. II. Induced changes in bile composition and gallstone response.
MedLine Citation:
PMID:  628065     Owner:  NLM     Status:  MEDLINE    
Changes in bile saturation and biliary bile acid composition in patients with gallstones who received chenodeoxycholic ("chenic") acid, cholic acid, or placebo were measured. Chenodeoxycholic induced bile desaturation; this effect was attributable solely to a decrease in the proportion of cholesterol. By gas chromatography, chenodeoxycholic acid increased substantially in the biliary bile acids of patients receiving it, and by mass spectrometry, no unusual bile acids were detected in appreciable amounts. Changes in bile saturation and biliary bile acid composition were then related to chenodeoxycholic acid dosage, and all of these variables were, in turn, related to gallstone response. In general, patients whose gallstones dissolved ingested a higher dose of chenodeoxycholic acid or had bile that contained a higher proportion of this acid and it was more unsaturated, but there were many exceptions, casting doubt on the value of a single analysis of fasting-state bile for predicting gallstone dissolutions. The major factor influencing response, provided dosage is adequate, appears to be gallstone type. Nonetheless, the proportion of chenodeoxycholic acid in biliary bile acids can probably be used to infer patient compliance.
A F Hofmann; J L Thistle; P D Klein; P A Szczepanik; P Y Yu
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  JAMA     Volume:  239     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1978 Mar 
Date Detail:
Created Date:  1978-04-26     Completed Date:  1978-04-26     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1138-44     Citation Subset:  AIM; IM    
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MeSH Terms
Bile / metabolism*
Bile Acids and Salts / analysis*
Chenodeoxycholic Acid / therapeutic use*
Cholelithiasis / drug therapy*,  metabolism
Cholesterol / analysis
Cholic Acids / therapeutic use
Chromatography, Gas
Reg. No./Substance:
0/Bile Acids and Salts; 0/Cholic Acids; 0GEI24LG0J/Chenodeoxycholic Acid; 97C5T2UQ7J/Cholesterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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