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Bile Acids, Liver Cirrhosis, and Extrahepatic Vascular Dysfunction
Tilman Sauerbruch1, Martin Hennenberg2, Jonel Trebicka3
1Department of Internal Medicine I, University of Bonn, Bonn, Germany.
Frontiers in Physiology
|August 16, 2021
Summary
Altered bile acids (BA) in liver cirrhosis may contribute to circulatory issues, but evidence is limited. Further research is needed to confirm if modifying bile acid pools impacts liver cirrhosis hemodynamics.
Area of Science:
- Gastroenterology and Hepatology
- Cardiovascular Physiology
- Microbiome Research
Background:
- Bile acids (BA) are crucial in enterohepatic circulation, regulated by the liver, gallbladder, and gut bacteria.
- Nuclear receptors like Farnesoid X Receptor (FXR) and Gpbar1 (TGR5) play key roles in bile acid metabolism.
- Bile acids exhibit vasodilatory effects, particularly noted in in vitro studies.
Purpose of the Study:
- To investigate the potential role of elevated plasma bile acids in the hyperdynamic circulatory disturbance of liver cirrhosis.
- To assess whether modulating the bile acid pool or gut dysbiosis can influence hemodynamic disorders in liver cirrhosis.
Main Methods:
- Review of existing literature on bile acid metabolism and liver cirrhosis.
- Analysis of the relationship between bile acid levels and circulatory disturbances.
- Evaluation of potential therapeutic strategies involving bile acid modulation (e.g., UDCA) and microbiome interventions.
Main Results:
- The evidence linking increased plasma bile acids to hyperdynamic circulation in liver cirrhosis is currently limited.
- The impact of modulating bile acid pools or gut dysbiosis on liver cirrhosis hemodynamics requires further investigation.
Conclusions:
- The current evidence supporting a significant role for bile acids in the hyperdynamic circulatory disturbance of liver cirrhosis is limited.
- Long-term studies are necessary to elucidate the precise relationship and potential therapeutic benefits of bile acid modulation in liver cirrhosis.
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