[Treatment of cholestatic liver diseases]

MODE OF ACTION OF URSODEOXYCHOLIC ACID: In cholestasis, the impaired biliary secretion of toxic bile acids causes their accumulation in the liver and a subsequent hepatic failure. This bile acid-induced liver damage can be treated successfully with the atoxic ursodeoxycholic acid (UDCA). This bile acid is formed by 7-beta-epimerization of chenodeoxycholic acid by intestinal bacteria. It represents 1-3% of the total human bile acid pool. The hepatocellular content of toxic bile acids is reduced by UDCA. This protects the liver cell from injury by toxic bile acids. THERAPEUTIC RESULTS: The therapeutic effect of UDCA in primary biliary cirrhosis has been demonstrated. Furthermore, numerous other cholestatic liver diseases benefit from UDCA treatment. The autoimmune pathogenesis of cholestatic liver diseases, e.g., primary biliary cirrhosis, might reveal an additional beneficial effect of a combination therapy with UDCA and immunosuppressive substances.