Document Detail


Targets for current pharmacologic therapy in cholesterol gallstone disease.
MedLine Citation:
PMID:  20478485     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Gallstone disease is a frequent condition throughout the world and, cholesterol stones are the most frequent form in Western countries. The standard treatment of symptomatic gallstone subjects is laparoscopic cholecystectomy. The selection of patients amenable for nonsurgical, medical therapy is of key importance; a careful analysis should consider the natural history of the disease and the overall costs of therapy. Only patients with mild symptoms and small, uncalcified cholesterol gallstones in a functioning gallbladder with a patent cystic duct are considered for oral litholysis by hydrophilic ursodeoxycholic acid, in the hope of achieving cholesterol desaturation of bile and progressive stone dissolution. Recent studies have raised the possibility that cholesterol-lowering agents that inhibit hepatic cholesterol synthesis (statins) or intestinal cholesterol absorption (ezetimibe), or drugs acting on specific nuclear receptors involved in cholesterol and bile acid homeostasis, may offer, alone or in combination, additional medical therapeutic tools for treating cholesterol gallstones. Recent perspectives on medical treatment of cholesterol gallstone disease are discussed in this article.
Authors:
Agostino Di Ciaula; David Q H Wang; Helen H Wang; Leonilde Bonfrate; Piero Portincasa
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Gastroenterology clinics of North America     Volume:  39     ISSN:  1558-1942     ISO Abbreviation:  Gastroenterol. Clin. North Am.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-18     Completed Date:  2010-10-12     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  8706257     Medline TA:  Gastroenterol Clin North Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  245-64, viii-ix     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Division of Internal Medicine, Hospital of Bisceglie, Bisceglie (Bari), Italy.
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MeSH Terms
Descriptor/Qualifier:
Azetidines / therapeutic use*
Cholesterol / metabolism*
Cholinergic Antagonists / therapeutic use*
Gallstones / drug therapy*,  metabolism
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Intestinal Absorption / drug effects*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
DK54012/DK/NIDDK NIH HHS; DK73917/DK/NIDDK NIH HHS; R01 DK054012-11/DK/NIDDK NIH HHS; R01 DK073917-03/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Azetidines; 0/Cholinergic Antagonists; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 163222-33-1/ezetimibe; 57-88-5/Cholesterol
Comments/Corrections

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