Related Experiment Video

Updated: Jul 17, 2026

Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport
08:42

Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport

Published on: November 27, 2016

Effect of ursodeoxycholic acid therapy on hepatic function in children with intrahepatic cholestatic liver disease

M R Narkewicz1, D Smith, C Gregory

  • 1Department of Pediatrics, University of Colorado School of Medicine, Denver, USA.

Journal of Pediatric Gastroenterology and Nutrition
|January 27, 1998
PubMed

Insights

Ursodeoxycholic acid (UDCA) improved itching and liver enzymes in children with cholestatic liver disease. However, it did not enhance quantitative measures of liver function in this pediatric population.

Area of Science:

  • Pediatric Hepatology
  • Gastroenterology
  • Pharmacology

Background:

  • Intrahepatic cholestatic liver disease affects children, causing symptoms like pruritus and biochemical abnormalities.
  • Ursodeoxycholic acid (UDCA) is used to manage these conditions, but its impact on quantitative liver function tests in pediatric patients remains unclear.

Purpose of the Study:

  • To evaluate the effect of Ursodeoxycholic acid (UDCA) on clinical symptoms, biochemical markers, and quantitative measures of hepatic function in children with intrahepatic cholestasis.

Main Methods:

  • A 2.5-year open-label crossover study involving 13 children with intrahepatic cholestasis.
  • UDCA was administered at 15-20 mg/kg/day for 12 months, followed by a 6-month washout, and then another 12 months of treatment.
  • Assessed clinical symptoms, liver enzymes (ALT, gamma-glutamyl transpeptidase), mineral levels, and quantitative tests including galactose and caffeine elimination half-lives (t1/2) and hepatic scintigraphy.

Main Results:

  • UDCA improved pruritus in affected patients and significantly reduced ALT, gamma-glutamyl transpeptidase, copper, and manganese levels at 12 months.
  • Galactose elimination half-life (t1/2) increased after 12 months of UDCA, but caffeine t1/2 and hepatic scintigraphy showed no significant changes.
  • Discontinuation of UDCA led to a rapid increase in ALT or worsening pruritus, prompting re-initiation of therapy in most patients.

Conclusions:

  • Ursodeoxycholic acid (UDCA) effectively alleviates pruritus and improves certain biochemical markers like ALT in pediatric intrahepatic cholestasis.
  • Despite these improvements, UDCA therapy did not demonstrate a significant positive impact on quantitative measures of liver function, such as elimination half-lives or scintigraphy, in this study population.
Abstract

More Related Videos

Partial Bile Duct Ligation in the Mouse: A Controlled Model of Localized Obstructive Cholestasis04:38

Partial Bile Duct Ligation in the Mouse: A Controlled Model of Localized Obstructive Cholestasis

Published on: March 28, 2018

Related Concept Videos

Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation. 
Hepatic Drug Excretion: Enterohepatic Cycling01:17

Hepatic Drug Excretion: Enterohepatic Cycling

Enterohepatic cycling involves the active secretion of drugs and their metabolites into the bile via transporters in the canalicular membrane of hepatocytes. This secretion is an integral part of the digestive process, releasing these substances into the gastrointestinal (GI) tract.
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...