Therapeutic and Chemopreventive Effects of Ursodeoxycholic Acid (UDCA): Potential Role in Patients with Barrett’s Esophagus
Ursodeoxycholic Acid is widely used for the treatment of cholestatic liver
diseases.
Major mechanisms of this action are protection of cholangiocytes
against cytotoxicity of hydrophobic bile acids, stimulation of hepatobiliary
secretion, and protection of hepatocytes against bile acid induced apoptosis.
UDCA has also been shown to modulate mitochondrial transmembrane
potential and prevent increases in mitochondrial Reactive Oxygen Species production.
Moreover, UDCA has been shown to have a Chemopreventive role in mouse
models of colon cancer and in patients with primary sclerosing cholangitis and
concomitant Inflammatory Bowel Disease (IBD), low dose UDCA lowers the risk
of IBD-associated colorectal neoplasia.
Our studies suggest that oral UDCA may protect against DNA damage induced by
hydrophobic bile acids such as Deoxycholic acid (DCA) in the metaplastic mucosa
of patients with Barrett’s esophagus.
We have found that DCA induces carcinogenic DNA damage in Barrett’s metaplasia.
UDCA which counters the DNA damaging effects of DCA therefore might
have a role as a Chemopreventive agent in Barrett’s metaplasia.
Future clinical studies on the use of UDCA for chemoprevention in patients
with Barrett’s esophagus should be considered.
Hammarsten isolated the previously unknown bile acid from the gallbladder of
the Polar bear naming it “Ursochoeinsaure”.
Twenty-five years later, Shodawas able to crystalize this bile acid from
a commercial preparation of Black bear bile and renamed it UDCA.
Unlike Black bears in which UDCA is a primary bile acid, UDCA is a secondary bile
acid in humans.
Currently, UDCA is US Food and Drug Administration approved to
treat patients with Primary Biliary Cirrhosis (PBC) that have abnormal liver tests.
Gastro Open J. 2015; 1(4): 89-93. doi: 10.17140/GOJ-1-115
