Bile acids are specific components of bile that are the end product of cholesterol metabolism in the liver. Today we will talk about the function of bile acids and what is their importance in the processes of digestion and assimilation of food.

The role of bile acids

- organic compounds that are of great importance for the normal course of digestive processes. These are derivatives of cholanic acid (steroidal monocarboxylic acids), which are formed in the liver and, together with bile, are excreted into the duodenum. Their main purpose is to emulsify dietary fats and activate the lipase enzyme, which is produced by the pancreas to utilize lipids. Thus, it is the bile acids that play a decisive role in the process of splitting and absorption of fats, which is an important factor in the process of digestion of food.

The bile produced by the human liver contains the following bile acids:

• cholic;
• chenodeoxycholic;
• deoxycholic.

In percentage terms, the content of these compounds is represented by the ratio 1:1:0.6. In addition, small amounts of bile contain organic compounds such as allocholic, lithocholic and ursodeoxycholic acids.

Today, scientists have more complete information about the metabolism of bile acids in the body, about their interaction with proteins, fats and cellular structures. In the internal environment of the body, bile compounds play the role of surfactants. That is, they do not penetrate cell membranes, but regulate the course of intracellular processes. Using the latest research methods, it has been established that bile acids affect the functioning of various parts of the nervous, respiratory systems and the digestive tract.

Functions of bile acids

Due to the fact that hydroxyl groups and their salts, which have detergent properties, are present in the structure of bile acids, acidic compounds are able to break down lipids, participate in their digestion and absorption into the intestinal walls. In addition, bile acids perform the following functions:

• promote the growth of beneficial intestinal microflora;
• regulate the synthesis of cholesterol in the liver;
• participate in the regulation of water-electrolyte metabolism;
• neutralize aggressive gastric juice entering the intestine with food;
• help to increase intestinal motility and prevent constipation:
• exhibit a bactericidal effect, suppress putrefactive and fermentation processes in the intestine;
• dissolve the products of lipid hydrolysis, which contributes to their better absorption and rapid transformation into substances ready for metabolism.

The formation of bile acids occurs during the processing of cholesterol by the liver. After food enters the stomach, the gallbladder contracts and ejects a portion of bile into the duodenum. Already at this stage, the process of splitting and assimilation of fats and the absorption of fat-soluble vitamins - A, E, D, K - begin.

After the food bolus reaches the final sections of the small intestine, bile acids appear in the blood. Then, in the process of blood circulation, they enter the liver, where they are combined with bile.

Synthesis of bile acids

Bile acids are synthesized by the liver. This is a complex biochemical process based on the excretion of excess cholesterol. In this case, 2 types of organic acids are formed:

• Primary bile acids (cholic and chenodeoxycholic) are synthesized by liver cells from cholesterol, then conjugated with taurine and glycine, and secreted in bile.
• Secondary bile acids (lithocholic, deoxycholic, allocholic, ursodeoxycholic) are formed in the large intestine from primary acids under the action of enzymes and intestinal microflora. Microorganisms contained in the intestine can form more than 20 varieties of secondary acids, but almost all of them (except lithocholic and deoxycholic) are excreted from the body.

The synthesis of primary bile acids takes place in two stages - first bile acid esters are formed, then the stage of conjugation with taurine and glycine begins, resulting in the formation of taurocholic and glycocholic acids.

In gallbladder bile, there are precisely paired bile acids - conjugates. The process of bile circulation in a healthy body occurs from 2 to 6 times a day, this frequency directly depends on the diet. In the process of circulation, about 97% of fatty acids undergo a process of reabsorption in the intestine, after which they enter the liver with the bloodstream and are again excreted in the bile. Bile salts (sodium and potassium cholates) are already present in hepatic bile, which explains its alkaline reaction.

The structure of bile and paired bile acids is different. Paired acids are formed by combining simple acids with taurine and glycocol, which increases their solubility and surface-active properties several times. Such compounds contain in their structure a hydrophobic part and a hydrophilic head. The conjugated bile acid molecule unfolds so that its hydrophobic arms are in contact with the fat and the hydrophilic ring is in contact with the aqueous phase. This structure makes it possible to obtain a stable emulsion, since the process of crushing a drop of fat is accelerated, and the resulting smallest particles are absorbed and digested faster.

Bile acid metabolism disorders

Any violations of the synthesis and metabolism of bile acids lead to malfunctions of the digestive processes and liver damage (up to cirrhosis).

A decrease in the volume of bile acids leads to the fact that fats are not digested and absorbed by the body. In this case, the mechanism of absorption of fat-soluble vitamins (A, D, K, E) fails, which causes hypovitaminosis. Vitamin K deficiency leads to impaired blood clotting, which increases the risk of internal bleeding. A lack of this vitamin is indicated by steatorrhea (a large amount of fat in the feces), the so-called "fat stool". Reduced levels of bile acids are observed with obstruction (blockage) of the biliary tract, which provokes a violation of the production and stagnation of bile (cholestasis), obstruction of the hepatic ducts.

Elevated bile acids in the blood cause the destruction of red blood cells, a decrease in the level, and a decrease in blood pressure. These changes occur against the background of destructive processes in the liver cells and are accompanied by symptoms such as pruritus and jaundice.

One of the reasons affecting the decrease in the production of bile acids may be intestinal dysbacteriosis, accompanied by increased reproduction of pathogenic microflora. In addition, there are many factors that can affect the normal course of digestive processes. The doctor's task is to find out these causes in order to effectively treat diseases associated with impaired metabolism of bile acids.

Bile acid analysis

To determine the level of bile compounds in the blood serum, the following methods are used:

• colorimetric (enzymatic) tests;
• immunoradiological study.

The radiological method is considered the most informative, with the help of which it is possible to determine the level of concentration of each component of bile.

To determine the quantitative content of the components, biochemistry (biochemical research) of bile is prescribed. This method has its drawbacks, but allows you to draw conclusions about the state of the biliary system.

So, an increase in the level of total bilirubin and cholesterol indicates cholestasis of the liver, and a decrease in the concentration of bile acids against the background of elevated cholesterol indicates colloidal instability of bile. If there is an excess of the level of total protein in the bile, they speak of the presence of an inflammatory process. A decrease in the lipoprotein index of bile indicates a violation of the functions of the liver and gallbladder.

To determine the yield of bile compounds, feces are taken for analysis. But since this is a rather laborious method, it is often replaced by other diagnostic methods, including:

• Bile sequestration test. During the study, the patient is given cholestyramine for three days. If against this background there is an increase in diarrhea, it is concluded that the absorption of bile acids is impaired.
• Test using homotaurocholic acid. During the study, a series of scintigrams is made within 4-6 days, which allows you to determine the level of bile malabsorption.

When determining the dysfunction of the metabolism of bile acids, in addition to laboratory methods, they additionally resort to instrumental diagnostic methods. The patient is referred for an ultrasound scan of the liver, which allows assessing the condition and structure of the parenchyma of the organ, the volume of pathological fluid accumulated during inflammation, identifying a violation of the patency of the bile ducts, the presence of calculi and other pathological changes.

In addition, the following diagnostic techniques can be used to detect pathologies of bile synthesis:

• x-ray with a contrast agent;
• cholecystocholangiography;
• percutaneous transhepatic cholangiography.

Which diagnostic method to choose, the attending physician decides individually for each patient, taking into account age, general condition, clinical picture of the disease and other nuances. The specialist selects the course of treatment based on the results of a diagnostic examination.

Features of therapy

As part of complex treatment for digestive disorders, bile acid sequestrants are often prescribed. This is a group of lipid-lowering drugs, the action of which is aimed at lowering the level of cholesterol in the blood. The term "sequestrant" in literal translation means "isolator", that is, such drugs bind (isolate) cholesterol and those bile acids that are synthesized from it in the liver.

Sequestrants are needed to lower low-density lipoprotein (LDL) levels, or the so-called "bad cholesterol", high levels of which increase the risk of developing severe cardiovascular disease and atherosclerosis. Blockage of arteries with cholesterol plaques can lead to stroke, heart attack, and the use of sequestrants can solve this problem, avoid coronary complications by reducing the production of LDL and its accumulation in the blood.

Additionally, sequestrants reduce the severity of itching that occurs when the bile ducts are blocked and their patency is impaired. Popular representatives of this group are drugs Colesteramine (Cholesteramine), Colestipol, Kolesevelam.

Bile acid sequestrants can be taken long-term because they are not absorbed into the blood, but their use is limited by poor tolerability. In the course of treatment, dyspeptic disorders, flatulence, constipation, nausea, heartburn, bloating, and changes in taste sensations often occur.

Today, sequestrants are being replaced by another group of lipid-lowering drugs - statins. They show the best efficiency and have fewer side effects. The mechanism of action of such drugs is based on the inhibition of enzymes responsible for the formation. Only the attending physician can prescribe medications of this group after laboratory tests that determine the level of cholesterol in the blood.

Representatives of statins are drugs Pravastatin, Rosuvastatin, Atorvastatin, Simvastatin, Lovastatin. The benefits of statins as drugs that reduce the risk of heart attack and stroke are undeniable, but when prescribing drugs, the doctor must take into account possible contraindications and adverse reactions. Statins have fewer of them than sequestrants, and the drugs themselves are easier to tolerate, however, in some cases, there are negative consequences and complications caused by taking these drugs.

BILE ACIDS(syn. cholic acids) - organic acids that are specific components of bile and play an important role in the digestion and absorption of fats, as well as in some other processes occurring in the gastrointestinal tract, including the transfer of lipids in the aquatic environment. Zh. to. are also the end product of metabolism (see), which is excreted from the body mainly in the form of Zh. to.

According to its chem. nature Zh. to. are derivatives of cholanic to - you (C 23 H 39 COOH), one, two or three hydroxyl groups are attached to a ring structure a cut. Side chain Zh. to., as well as in a molecule of cholanic to - you, includes 5 carbon atoms with COOH group on the end.

Human bile contains: cholic (3-alpha, 7-alpha, 12-alpha-trioxy-5-beta-cholanic) to - that:

chenodeoxycholic (anthropodeoxycholic) (3-alpha, 7-alpha-dioxi-5-beta-cholanic) to - that:

and deoxycholic (3-alpha, 12-alpha-dioxi-5-beta-cholanic) to - that:

in addition, in small quantities or in the form of traces, lithocholic (3-alpha-monooxy-5-beta-cholanic), as well as allocholic and ursodeoxycholic to-you are stereoisomers of cholic and chenodeoxycholic to-t. All Zh. to. are present in bile (see) in a conjugated form. Some of them are conjugated with glycine (glycocol) to glycocholic or glycochenodeoxycholic acid, and some of them are conjugated with taurine to taurocholic:

or taurochenodeoxycholic acid. In hepatic bile, fatty acids dissociate and are in the form of bile salts of sodium and potassium (cholates and deoxycholates of Na and K), which is explained by the alkaline pH of bile (7.5-8.5).

Of all Zh. to. only cholic and chenodeoxycholic to-you are primarily formed in the liver (they are called primary), while others are formed in the intestine under the influence of enzymes of the intestinal microflora and are called secondary. They are absorbed into the blood and then re-secreted by the liver as bile.

In non-microbial animals grown under sterile conditions, only cholic and chenodeoxycholic acids are present in the bile, while deoxycholic and lithocholic acids are absent and appear in the bile only with the introduction of microorganisms into the intestines. This confirms the secondary formation of these fatty acids in the intestine under the influence of microflora from cholic and chenodeoxycholic to-t, respectively.

Primary fatty acids are formed in the liver from cholesterol.

This process is quite complicated, because F. to. differ from cholesterol in stereochemical. configuration of two regions of the molecule. The hydroxyl group at the 3rd C-atom in the Zh. molecule is in the alpha position, and in the cholesterol molecule it is in the beta position. Hydrogen at the 3rd C-atom of fatty acids is in the p-position, which corresponds to the trans-configuration of rings A and B, and in cholesterol - in the a-position (cis-configuration of rings A and B). In addition, Zh. to. contain a greater number of hydroxyl groups, a shorter side chain, which is characterized by the presence of a carboxyl group.

The process of converting cholesterol to cholic acid begins with the hydroxylation of cholesterol in the 7alpha position, i.e., with the inclusion of the hydroxyl group in position 7, followed by the oxidation of the OH group at the 3rd C-atom to the keto group, the displacement of the double bond from 5 -th C-atom to the 4th C-atom, hydroxylation at the 12-alpha position, etc. All these reactions are catalyzed by microsomal liver enzymes in the presence of NAD H or NADP H. Oxidation of the side chain in the cholesterol molecule is carried out with the participation of a series dehydrogenases in the presence of ATP, CoA and Mg 2+ ions. The process goes through the stage of formation of 3-alpha, 7-alpha, 12-alpha-trioxicoprostanic acid, which then undergoes beta-oxidation. In the final stage, a three-carbon fragment, which is propionyl-CoA, is separated, and the side chain of the molecule, thus, is shortened. The sequence of these reactions in some links may vary. For example, the formation of a keto group at the 3-beta position may occur not before, but after hydroxylation at the 12-alpha position. However, this does not change the main direction of the process.

The process of formation of chenodeoxycholic to-you from cholesterol has some features. In particular, the oxidation of the side chain to form a hydroxyl at the 26th carbon atom can begin at each stage of the process, with the hydroxylated product further involved in the reactions in the usual sequence. It is possible that the early attachment of the OH group to the 26th C-atom compared to the usual course of the process is an important factor in the regulation of the synthesis of chenodeoxycholic acid. It has been established that this to-that is not a precursor of cholic and does not turn into it; likewise, cholic acid in the human body and animals does not turn into chenodeoxycholic acid.

Conjugation Zh. to. proceeds in two stages. The first stage consists in the formation of acyl-CoA, i.e., CoA-esters of fatty acids. For primary fatty acids, this stage is already carried out at the final stage of their formation. The second stage of conjugation of fatty acids - actually Conjugation - consists in the connection by means of an amide bond of the molecule of fatty acids with glycine or taurine. This process is catalyzed by lysosomal acyltransferase.

In human bile, the main fatty acids - cholic, chenodeoxycholic and deoxycholic - are in a quantitative ratio of 1: 1: 0.6; glycine and taurine conjugates of these to-t - in a ratio of 3:1. The ratio between these two conjugates varies depending on the nature of the food: in the case of the predominance of carbohydrates in it, the relative content of glycine conjugates increases, and with a high-protein diet, taurine conjugates. Corticosteroid hormones increase the relative content of taurine conjugates in bile. On the contrary, in diseases accompanied by protein deficiency, the proportion of glycine conjugates increases.

The ratio of glycine-conjugated to taurine-conjugated fatty acids in humans changes under the influence of thyroid hormone, increasing in the hypothyroid state. In addition, in patients with hypothyroidism, cholic acid has a longer half-life and is more slowly metabolized than in patients with hyperthyroidism, which is accompanied by an increase in blood cholesterol in patients with reduced thyroid function.

In animals and humans, castration increases blood cholesterol levels. In the experiment, a decrease in the concentration of cholesterol in the blood serum and an increase in the formation of fatty acids were observed with the introduction of estrogen. Nevertheless, the effect of hormones on the biosynthesis of fatty acids has not been studied enough.

In the bile of various animals, the composition of the gallbladder varies greatly. Many of them have Zh. to., which are absent in humans. So, in some amphibians, the main component of bile is cyprinol - bile alcohol, which, unlike cholic acid, has a longer side chain with two hydroxyl groups at the 26th and 27th carbon atoms. This alcohol conjugates predominantly with sulfate. Other amphibians are dominated by the bile alcohol bufol, which has OH groups at the 25th and 26th carbon atoms. In pig bile, there is a hyocholic acid with an OH group in the position of the 6th carbon atom (3-alpha, 6-alpha, 7-alpha-trioxycholanic acid). Rats and mice have alpha and beta maricholic to-you - stereoisomers of giocholic to-you. In animals eating plant foods, chenodeoxycholic acid predominates in bile. For example, in a guinea pig, it is the only one of the main Zh. to. Holevy to - that, on the contrary, is more characteristic of carnivores.

One of the main functions of liquid acids, the transfer of lipids in an aqueous medium, is associated with their detergent properties, that is, with their ability to dissolve lipids by forming a micellar solution. These properties of bile are already manifested in the liver tissue, where, with their participation, micelles are formed (or finally formed) from a number of bile components, which are called the bile lipid complex. Due to the inclusion in this complex, lipids secreted by the liver and some other substances poorly soluble in water are transferred to the intestine in the form of a homogeneous solution as part of bile.

In intestines salts Zh. to. participate in fat emulsification. They are part of the emulsifying system, which includes saturated monoglyceride, unsaturated fatty acid, and salts of fatty acids. At the same time, they play the role of stabilizers of the fat emulsion. Zh. to. also perform an important role as a kind of activator of pancreatic lipase (see). Their activating effect is expressed in a shift in the optimum action of lipase, which, in the presence of fatty acids, moves from pH 8.0 to pH 6.0, i.e., to that pH value, which is more constantly maintained in the duodenum during digestion fatty food.

After the splitting of fat by lipase, the products of this splitting - monoglycerides and fatty acids (see) form a micellar solution. A decisive role in this process is played by salts of fatty acids. Due to their detergent action, micelles are formed in the intestines that are stable in an aqueous medium (see Molecule), containing fat breakdown products, cholesterol, and often phospholipids. In this form, these substances are transferred from the emulsion particles, i.e., from the site of lipid hydrolysis, to the suction surface of the intestinal epithelium. In the form of a micellar solution, formed with the participation of salts. to., are transferred to went. - kish. tract and fat-soluble vitamins. Switching off Zh. to. from digestive processes, eg, at experimental assignment of bile from intestines, leads to decrease in absorption of fat in went. - kish. tract by 50% and to malabsorption of fat-soluble vitamins up to the development of vitamin deficiency phenomena, for example, vitamin K deficiency. In addition, Zh. to. significant changes.

Having fulfilled its fiziol, role in the intestines, Zh. to. in an overwhelming amount are absorbed into the blood, return to the liver and are again secreted as part of bile. Occurs, thus, constant circulation Zh. to. between a liver and intestines. This process is called hepato-intestinal (enterohepatic or portal-biliary) circulation Zh. to.

The bulk of the Zh. to. is absorbed in a conjugated form in the ileum. In the proximal part of the small intestine, a certain amount of Zh. to. passes into the blood by passive absorption.

Studies conducted using labeled 14 C fatty acids showed that bile contains only a small part of the fatty acids newly synthesized by the liver [S. Bergstrom, Danielsson (H. Danielsson), 1968]. They account for only 10-15% of the total amount of bile. Zh. to., participating in hepato-intestinal circulation. The total pool of fatty acids in a person averages 2.8-3.5 g, and they make 5-6 revolutions per day. In different animals, the number of revolutions made by the gallbladder per day varies greatly: in a dog it is also 5-6, and in a rat 10-12.

Part Zh. to. is exposed to deconjugation in the intestine under the influence of normal intestinal microflora. At the same time, a certain amount of them loses their hydroxyl group, turning into deoxycholic, lithocholic, or other acids. All of them are absorbed and, after conjugation in the liver, are secreted in the bile. However, after deconjugation, 10-15% of all the fatty acids that enter the intestine are subjected to deeper degradation. As a result of the processes of oxidation and reduction caused by the enzymes of the microflora, these fatty acids undergo various changes, accompanied by a partial rupture of their ring structure. A number of products formed are then excreted in the faeces.

The biosynthesis of fatty acids is controlled according to the type of negative feedback by a certain amount of fatty acids that return to the liver in the process of hepato-intestinal circulation.

It has been shown that different fluids have qualitatively and quantitatively different regulatory effects. In humans, for example, chenodeoxycholic acid inhibits the formation of cholic acid.

An increase in the content of cholesterol in food leads to an increase in the biosynthesis of fatty acids.

Destruction and release of part Zh. to, represent the major way of excretion of end products of an exchange of cholesterol. It has been shown that in non-microbial animals devoid of intestinal microflora, the number of turns made by the gallbladder between the liver and intestines is reduced, and the excretion of gallbladder with faeces is sharply reduced, which is accompanied by an increase in the content of cholesterol in the blood serum.

Thus, a fairly intense secretion of fatty acids in the composition of bile and their transformation in the intestine under the influence of microflora are extremely important both for digestion and for cholesterol metabolism.

Normally, a person’s urine does not contain fatty acids; very small amounts of them appear in the urine with obstructive jaundice (early stages) and acute pancreatitis. Zh. to. are the strongest choleretics, for example, dehydrocholic acid (see). This property of Zh. to. is used to introduce them into the composition of choleretic agents (see) - decholine, allochol, etc. Zh. to. stimulate intestinal motility. Constipation observed in patients with jaundice may be due to a deficiency of cholates (salts Zh. to.). However, the simultaneous intake of a large number of conc. bile into the intestines, and with it a large amount of Zh. to., observed in a number of patients after removal of the gallbladder, can cause diarrhea. Besides, Zh. to. possess bacteriostatic action.

The total concentration of fatty acids in the blood and their ratio change significantly in a number of diseases of the liver and gallbladder, which is used for diagnostic purposes. With parenchymal lesions of the liver, the ability of liver cells to capture fatty acids from the blood is sharply reduced, as a result of which they accumulate in the blood and are excreted in the urine. An increase in the concentration of fatty acids in the blood is also observed with difficulty in the outflow of bile, especially with obstruction of the common bile duct (stone, tumor), which is also accompanied by a violation of the hepato-intestinal circulation with a sharp decrease or disappearance of deoxycholate conjugates from bile. A prolonged and significant increase in the concentration of fatty acids in the blood can have a damaging effect on liver cells with the development of necrosis and changes in the activity of certain enzymes in the blood serum.

A high concentration of cholates in the blood causes bradycardia and hypotension, pruritus, hemolysis, an increase in the osmotic resistance of erythrocytes, disrupts blood coagulation processes, and slows down the erythrocyte sedimentation rate. With allocation at diseases of a liver Zh. to. through kidneys connect development of a renal failure.

In acute and hron, cholecystitis, a decrease in the concentration or complete disappearance of cholates from gallbladder bile is observed, which is explained by a decrease in their formation in the liver and an acceleration of their absorption by the mucous membrane of the inflamed gallbladder.

Zh. to. and their derivatives destroy blood cells, including leukocytes, within a few minutes, which should be taken into account when assessing the diagnostic value of the number of leukocytes in the duodenal contents. Cholates also destroy tissues that are not in contact with bile in physiological conditions, cause an increase in membrane permeability and local inflammation. When bile enters, for example, severe peritonitis quickly develops into the abdominal cavity. In the mechanism of development of acute pancreatitis, antral gastritis, and even gastric ulcers, a certain role is assigned to Zh. to. The possibility of damage to the gallbladder itself is allowed. bile containing a large amount of Zh. to. ("chemical" cholecystitis).

Zh. to. are an initial product for production of steroid hormones. Due to the similarity of the chemical structure of steroid hormones and Zh. to. the latter have a pronounced anti-inflammatory effect. On this property Zh. to. the method of treatment of arthritises by local application konts is based. bile (see Bile).

For the treatment of diarrhea that occurs after the surgical removal of part of the intestine, and persistent skin itching in patients with diseases of the liver and biliary tract, drugs are used that bind Zh. to. in the intestine, for example, cholestyramine.

Bibliography: F. I. Komarov and A. I. Ivanov. Bile acids, physiological role, clinical significance, Ter. arch., vol. 44, no. 3, p. 10, 1972; Kuvaeva I. B. Metabolism and intestinal microflora, M., 1976, bibliogr.; Saratikov A. S. Bile formation and choleretic agents, Tomsk, 1962; Advances in hepatology, ed. E. M. Tareev and A. F. Bluger, c. 4, p. 141, Riga, 1973, bibliography; Bergstrom S. a. Danielsson H. Formation and metabolism of bile acids, Handb. Physiol., sect. 6, ed. by G. F. Code, p. 2391, Washington, 1968; The bile acids, chemistry, physiology and metabolism, ed. by P. P. Nair a. D. Kritshevsky, v. 1-2, N. Y., 1973, bibliogr.; Borgstrom B. Bile salts, Acta med. scand., v. 196, p. 1, 1974, bibliogr.; D a-nielsson H. a. S j o v a 1 1 J. Bile acid metabolism, Ann. Rev. Biochem., v. 44, p. 233, 1975, bibliogr.; Hanson R. F. a. o. Formation of bile acids in man, Biochim, biophys. Acta (Amst.), v. 431, p. 335, 1976; S h 1 y g i n G. K. Physiology of intestinal digestion, Progr, food Nutr., y. 2, p. 249, 1977, bibliogr.

G. K. Shlygin; F. I. Komarov (wedge).

Cholic acid plays a special role in the functioning of the liver structures,. Otherwise, cholic acid is called bile. It is produced in hepatocytes during the oxidative processes of cholesterol compounds. The amount of cholic acid produced by the adult body varies from 250 to 300 mg per day. The acid is contained in the cavity of the bladder and its ducts in the form of conjugates, which are double compounds of taurine and glycine (glycocolic and taurosolic acids in meaning). The liver plays not only a detoxifying function, it actively produces bile acids. Any errors in the volume of acid produced, as well as metabolic disorders of any genesis, there are difficulties with digestion, normal digestion of food, cleansing the body naturally.

Features of bile

Bile is produced in the liver and stored in The constituent components of bile are quite complex, they include protein compounds, acids, amino acids, certain types of hormones, special inorganic salts, and important pigments. At the time of a single meal, bile, with the help of muscle contractions, is thrown into the intestinal cavity, helping to crush and break down fatty substances in order to freely remove them into the intestines. Similarly, bilirubin is excreted into the intestine.

Bile promotes the absorption and absorption through the walls of the intestinal cavity of useful trace elements, inorganic salts, vitamin complexes, and takes part in the decomposition of triglycerides. Bile components allow you to stimulate the small intestine, secrete special substances and mucus. At the end of its function, bile is not excreted from the body in absolute volume. One part is absorbed into the blood, and the other part is returned back to the liver structures. Among other components, thyroid hormones are distinguished (for the normal functionality of the pituitary gland), vitamin complexes, and pigments.

Cholic acid

Cholic acid is the primary bile acid and makes up the majority of it. The chemical formula of cholic acid is C24H40O5 and is part of the group of monocarboxylic acids. In the liver structures, it is synthesized from cholesterol compounds, after several cholesterol intermediate reactions.

Acid features

The main functions of cholic acid include:

• grinding dietary fiber;
• solubilization and emulsification of fatty compounds;
• production of cholesterol in the liver;
• regulation of bile production;
• disinfecting effect;
• stimulation of intestinal motility;
• structure of the nervous system.

Much depends on the production of bile. In addition to maintaining liver function, cholic acid allows the production of certain hormonal substances, without which the normal functioning of the thyroid gland is impossible. In case of insufficiency of cholic acid or in its absolute absence (in acute deficiency), fats are not absorbed or are only partially absorbed, they are excreted along with intestinal stools. Fecal masses during defecation are painted in a light color.

Important! Low bile content is often attributed to alcoholism or regular consumption of alcoholic beverages. Due to the lack of useful substances necessary for the normal functioning of the liver, diseases of the lower intestines often develop, because it is this area of ​​​​the intestinal tract that is not adapted to the secretions of too much fat.

Human liver (anatomical location)

Medications

Cholic acid-based drugs are widely used to treat any liver disease, including viral hepatitis and its complications (fibrosis, cirrhosis, liver failure). Previously, the food supplement E-1000 was a huge content of cholic acid, but today it is excluded from the permitted list in the Russian Federation.
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Spectrum of medications

One of the well-known drugs for restoring liver function is Panzinorm Forte, as well as drugs based on purified ursodeoxycholic acid, which is found in pure form and in large quantities in bear bile. Such means include Urdox, Ursoliv, Ursodez, Livodex, Ursofalk, and others.

Important! From lat. "ursus" means bear, hence the name of many drugs based on ursodeoxycholic acid. Cholic acid can be a part of many vitamin complexes that provide prevention of hepatic diseases in adults and children, including intrauterine development.

Application features

The drug is indicated for the treatment of metabolic disorders and synthesis of bile acids, in the complex treatment of peroxisomal disorders, complications of liver tissues in chronic diseases. There are no contraindications to the use of cholic acid, no cases of overdose have been identified. With caution, it is recommended to use bile-based drugs for lactation, during gestation (all trimesters). Against the background of taking drugs, side effects and negative effects are possible, for example:

• peripheral neuropathy (polyneuropathy);
• urinary tract infection;
• (liquidity of a chair, morbidity);
• damage to the skin (rash resembling hives, redness);
• clinical jaundice;
• reflux diseases of the stomach.

Even with a slight deterioration in well-being, it is recommended to stop taking medications, consult a doctor for advice, the choice of alternative drugs.

Important! Reception of cholic acid should be stopped in severe liver disorders, with a deterioration in its function, cholestasis. With a burdened clinical history, if it is necessary to use drugs from other pharmacological groups, the attending physician should be told about this.

Substance synonyms are holal, holic, cholic acid from lat. Keep out of direct sunlight, away from children. Preparations based on bile require careful study of the instructions, and the reception is carried out only after the diagnosis and the chosen treatment by a hepatologist.

Cholic acid(English) cholic acid) is a monocarboxylic trihydroxy acid from the group of bile acids.

Cholic acid, along with chenodeoxycholic acid, is the most important bile acid for human physiology.

Cholic acid is the so-called primary bile acid, which is formed in the hepatocytes of the liver during the oxidation of cholesterol. The volume of production of cholic acid in an adult healthy person is from 200 to 300 mg per day. In the gallbladder, cholic acid is present mainly in the form of conjugates - paired compounds with glycine and taurine, called, respectively, glycocholic and taurocholic acids.

Cholic acid is the international non-proprietary name of the drug

Recently, cholic acid has been assigned a code according to the international Anatomical Therapeutic Chemical Classification - A05AA03 (section "A05 Drugs for the treatment of diseases of the liver and biliary tract").

Cholic acid as a drug component

In the United States, in March 2015, cholic acid was approved by the FDA for the treatment of rare diseases associated with impaired bile acid synthesis under the trade name Cholbam.

In Russia, monopreparations of cholic acid do not have permission to use.

Cholic acid, as one of the active ingredients, is part of the Panzinorm forte enzyme preparation, the first drug on the Russian market, from the group of drugs with the Panzinorm trademark. In subsequent preparations of the Panzinorm group, cholic acid is absent.

Cholic acid - food supplement

Cholic acid (Cholic Acid) is registered as a food additive with the international code E1000. The technological application of lipase in this capacity is anti-flaming, a glazing agent. However, cholic acid is not allowed for use in Russia as a food additive, as it has not passed the tests necessary for its registration.

According to its structure and chemical and physical parameters, food supplement E1000 Cholic acid is a monocarboxylic acid, which belongs to the group of bile acids. The main feature of these compounds can be considered that some bile monocarboxylic acids are found in the human body. It is worth noting that the food supplement E1000 Cholic acid belongs to the category of these acids. Cholic acid is nothing more than the primary secret that the human liver produces.

We can say that the food supplement E1000 Cholic acid belongs to the group of organic compounds of natural origin. The active acidic compound is formed as a result of the interaction and decomposition of acids such as glycocholic and taurocholic. Cholic acid is not only a breakdown product, but also the result of the crystallization of alcohols. It should be noted that according to its chemical structure, food additive E1000 Cholic acid belongs to the so-called monobasic acids.

Food additive E1000 begins to melt at a temperature of 195C, and also forms an ester when exposed to temperature on acetic anhydride. In addition, food additive E1000 Cholic acid enters into various reactions with other chemical reagents. This ability of the compound is actively used in the chemical industry, where the food additive E1000 is used to obtain other organically active compounds.

It is worth emphasizing that cholic acid is considered one of the most important bile monocarboxylic acids for the human body. In the human body, cholic acid occurs when cholesterol is oxidized by the liver. In the chemical industry, cholic acid is produced in the form of a white crystalline powder or peculiar plates, which are distinguished by a bitter taste, which gradually turns into sweet.

In the food industry, the food additive E1000 has found enough applications. This is primarily due to the chemical properties of the food additive, which can act as an emulsifier, antifoaming or glazing agent, as well as a sugar substitute or sweetener. In the food industry, it is allowed to use the food additive E1000 Cholic acid to stabilize the dispersed states of finished food products.

As a rule, food additive E1000 helps food manufacturers to form the necessary consistency of food products. Food additive E1000 Cholic acid can give products a certain level of viscosity and maintain it for a long period of storage. Usually E1000 can be found in the composition of bakery and confectionery products, as well as fruit and fruit juices.