[The pharmacological therapy of intrahepatic cholestasis]

Changes in liver membrane fluidity constitute one of the most important factors in the pathogenesis of experimental and human cholestasis. These alterations could partly be correlated with a defect in the methylation of membrane phospholipids and with a modification in the cholesterol/phospholipids ratio, which in turn may result from a decrease in the ademethionine hepatic levels and from a dysfunction of the enzymes involved in the ademethionine synthesis or in methylation processes, where ademethionine is a crucial factor. On the basis of these considerations, several trials have proved the protective effect of ademethionine in cholestasis and in hepatic disease with different etiology. As regard human pathology the efficacy of ademethionine was demonstrated firstly in intrahepatic cholestasis of pregnancy or estrogen-induced and later on in hepatic diseases with different etiology. These results are particularly encouraging since very few are the drugs effective in the treatment of intrahepatic cholestasis, which represents indeed a crucial element in hepatic diseases.