未经证实:根尖钠依赖性胆汁酸转运体(ASBT;也称为回肠胆汁酸转运体[IBAT])的非吸收性抑制剂最近被批准用于多种胆汁淤积性肝脏疾病或在临床开发中,并导致瘙痒和肝损伤(标志物)的减少。不幸的是,非吸收性ASBT抑制剂(ASBTi)可引起腹泻,如果胆汁淤积广泛且在很大程度上排除肠道胆汁酸排泄,则可能无效.全身作用的ASBTi将胆汁盐转向肾脏排泄可能会缓解这些问题。
未经证实:在ASBT缺陷(ASBT敲除[KO])小鼠中进行胆管结扎(BDL),作为阻塞性胆汁淤积中慢性全身性ASBT抑制的模型。放射性标记的牛磺胆酸盐和菊粉的共输注用于定量BDL后的肾胆盐排泄。在第二个(野生型)小鼠模型中,使用奥贝胆酸(OCA)和肠限制性ASBT抑制的组合来降低BDL前的胆汁盐池大小.
未授权:在BDL之后,与BDL的野生型小鼠相比,ASBTKO小鼠的血浆胆红素和碱性磷酸酶降低,并且在组织病理学分析中显示肝坏死区域显着减少,提示BDL诱导的肝损伤减少。此外,ASBTKO小鼠的胆汁盐池大小减少,下血浆牛磺酸共轭多羟基胆汁盐,和增加尿胆汁盐排泄。在野生型小鼠中用OCA+ASBTi预处理减小了池大小,并且极大地改善了肝损伤标志物和肝组织学。
未经证实:胆汁淤积发作时胆汁盐池减少可有效降低小鼠胆汁淤积性肝损伤。全身性ASBT抑制可能是有价值的治疗胆汁淤积性肝病通过降低池大小和增加肾胆汁盐输出,即使在最低限度的粪便胆汁盐分泌的条件下。
UNASSIGNED:针对胆汁淤积性肝病(导致胆汁流动减少或阻塞)的新治疗方法涉及胆汁酸转运蛋白ASBT的不可吸收抑制剂,但这些并不总是有效的和/或可能导致不必要的副作用。在这项研究中,我们证明,全身性抑制/失活ASBT保护小鼠免受胆管结扎后发生严重胆汁淤积性肝损伤,通过减少胆盐池大小和增加肾胆盐排泄。
UNASSIGNED: Non-absorbable inhibitors of the apical sodium-dependent bile acid transporter (ASBT; also called ileal bile acid transporter [IBAT]) are recently approved or in clinical development for multiple cholestatic liver disorders and lead to a reduction in pruritus and (markers for) liver injury. Unfortunately, non-absorbable ASBT inhibitors (ASBTi) can induce diarrhoea or may be ineffective if cholestasis is extensive and largely precludes intestinal excretion of bile acids. Systemically acting ASBTi that divert bile salts towards renal excretion may alleviate these issues.
UNASSIGNED: Bile duct ligation (BDL) was performed in ASBT-deficient (ASBT knockout [KO]) mice as a model for chronic systemic ASBT inhibition in obstructive cholestasis. Co-infusion of radiolabelled taurocholate and inulin was used to quantify renal bile salt excretion after BDL. In a second (wild-type) mouse model, a combination of obeticholic acid (OCA) and intestine-restricted ASBT inhibition was used to lower the bile salt pool size before BDL.
UNASSIGNED: After BDL, ASBT KO mice had reduced plasma bilirubin and alkaline phosphatase compared with wild-type mice with BDL and showed a marked reduction in liver necrotic areas at histopathological analysis, suggesting decreased BDL-induced liver damage. Furthermore, ASBT KO mice had reduced bile salt pool size, lower plasma taurine-conjugated polyhydroxylated bile salt, and increased urinary bile salt excretion. Pretreatment with OCA + ASBTi in wild-type mice reduced the pool size and greatly improved liver injury markers and liver histology.
UNASSIGNED: A reduced bile salt pool at the onset of cholestasis effectively lowers cholestatic liver injury in mice. Systemic ASBT inhibition may be valuable as treatment for cholestatic liver disease by lowering the pool size and increasing renal bile salt output even under conditions of minimal faecal bile salt secretion.
UNASSIGNED: Novel treatment approaches against cholestatic liver disease (resulting in reduced or blocked flow of bile) involve non-absorbable inhibitors of the bile acid transport protein ASBT, but these are not always effective and/or can cause unwanted side effects. In this study, we demonstrate that systemic inhibition/inactivation of ASBT protects mice against developing severe cholestatic liver injury after bile duct ligation, by reducing bile salt pool size and increasing renal bile salt excretion.