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Hou RG, Fan L, Liu JJ, Cheng Y, Chang ZP, Wu B, Shao YY. Bile acid malabsorption is associated with diarrhea in acute phase of colitis. Can J Physiol Pharmacol 2018; 96:1328-1336. [PMID: 30383974 DOI: 10.1139/cjpp-2018-0017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The enterohepatic circulation of bile acids (BAs) critically depends on BA transporters and enzymes, which can be affected by inflammatory bowel disease. Diarrhea in colitis is believed to result in part from BA malabsorption. The work aimed to investigate whether diarrhea in colitis was associated with the expression of BA transporters, enzymes, and nuclear receptors. RT-qPCR and Western blot techniques were used to evaluate the gene and protein levels of Cyp7a1, Asbt, SHP, FXR, Ostβ in a 2,4,6-trinitrobenzenesulfonic-acid-induced rat model of colitis. The total BAs (TBAs) levels were assayed using ELISA kits, and the individual BAs were measured by LC-MS/MS. Results showed that the fecal excretions of TBAs were significantly increased by 1.6-fold in acute stage of colitis. In ileum, Asbt was significantly decreased; however, there was a compensatory increase in Cyp7a1 level in liver. Moreover, FXR has a decreased tendency and the downstream target gene SHP was downregulated. Contrary to acute stage, molecular changes were completely reversible during the remission phase. Our results indicated that the expression of Asbt and Cyp7a1 were altered in acute colitis, which performed vital roles in maintaining BA homeostasis. Early medical manipulation of BA transporters and enzymes may help prevent diarrhea.
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Affiliation(s)
- Rui-Gang Hou
- a School of Pharmaceutical, Shanxi Medical University, Shanxi 030000 China.,b Department of Pharmacy, Second Hospital of Shanxi Medical University, Shanxi 030000, China
| | - Lei Fan
- a School of Pharmaceutical, Shanxi Medical University, Shanxi 030000 China.,b Department of Pharmacy, Second Hospital of Shanxi Medical University, Shanxi 030000, China
| | - Jun-Jin Liu
- a School of Pharmaceutical, Shanxi Medical University, Shanxi 030000 China.,b Department of Pharmacy, Second Hospital of Shanxi Medical University, Shanxi 030000, China
| | - Yao Cheng
- a School of Pharmaceutical, Shanxi Medical University, Shanxi 030000 China.,b Department of Pharmacy, Second Hospital of Shanxi Medical University, Shanxi 030000, China
| | - Zhuang-Peng Chang
- a School of Pharmaceutical, Shanxi Medical University, Shanxi 030000 China.,b Department of Pharmacy, Second Hospital of Shanxi Medical University, Shanxi 030000, China
| | - Bei Wu
- a School of Pharmaceutical, Shanxi Medical University, Shanxi 030000 China.,b Department of Pharmacy, Second Hospital of Shanxi Medical University, Shanxi 030000, China
| | - Yun-Yun Shao
- a School of Pharmaceutical, Shanxi Medical University, Shanxi 030000 China.,b Department of Pharmacy, Second Hospital of Shanxi Medical University, Shanxi 030000, China
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Mena Bares L, Carmona Asenjo E, García Sánchez M, Moreno Ortega E, Maza Muret F, Guiote Moreno M, Santos Bueno A, Iglesias Flores E, Benítez Cantero J, Vallejo Casas J. 75SeHCAT scan in bile acid malabsorption in chronic diarrhea. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.remnie.2016.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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75SeHCAT scan in bile acid malabsorption in chronic diarrhoea. Rev Esp Med Nucl Imagen Mol 2016; 36:37-47. [PMID: 27765536 DOI: 10.1016/j.remn.2016.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 08/30/2016] [Indexed: 12/19/2022]
Abstract
Chronic diarrhoea is a common entity in daily clinical practice and it leads to a loss in these patients quality of life. It may be the main symptom of multiple ethiologies including bile acid malabsorption (BAM) which has a comparable prevalence to celiac disease. The BAM results from imbalances in the homeostasis of bile acids in the enterohepatic circulation. It can be a consequence of ileal disease or ileal dysfunction (BAM type i), it can be considered idiopathic or primary (BAM type ii) or associated with other gastrointestinal entities (BAM type iii). Among the different diagnostic methods available, 75SeHCAT study is the primary current method due to its sensitivity, specificity, safety and low cost. The main disadvantage is that it's not available in all countries, so other diagnostic methods have appeared, such as serum measurement of FGF19 and C4, however they are significantly more complex and costly. The first-line treatment of bile acid diarrhoea is bile acid sequestrant, such as cholestyramine, which can be difficult to administer due to its poor tolerability and gastrointestinal side effects. These are less prominent with newer agents such as colesevelam. In summary, the BAM is a common entity underdiagnosed and undertreated, so it is essential to establish a diagnosis algorithm of chronic diarrhoea in which the 75SeHCAT study would be first or second line in the differential diagnosis of these patients.
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