Ursodeoxycholic acid
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| Non-proprietary name | Ursodeoxycholic acid | |||||||||||||||||||||
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| Molecular formula | C 24 H 40 O 4 | |||||||||||||||||||||
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| Molar mass | 392.56 g · mol -1 | |||||||||||||||||||||
| Physical state |
firmly |
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| Melting point |
203 ° C |
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| solubility |
almost insoluble in water (20 mg l −1 at 20 ° C) |
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| As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions . | ||||||||||||||||||||||
Ursodeoxycholic acid , also called ursodeoxycholic acid ( UDCA, UDCS ), is a natural, tertiary bile acid that is used as a medicinal substance to dissolve small gallstones and to treat a number of liver diseases. Chemically it is a steroid belonging to the group of sterols (sterols) . It is found in high concentrations in the bile of bears , especially the Asian black bear . Hence their name ( Latin ursus "the bear"). UDCA may also partial- synthetic be prepared by from the bile of cattle cholic acid extracted is, which is then chemically converted to UDCA. The UDCA used in approved drugs today is exclusively produced in this way. The substance is passively absorbed and is excreted in the enterohepatic circulation via the bile and partially absorbed again via the intestine. About three percent of UDCA is also found in human bile.
Mechanism of action
Ursodeoxycholic acid promotes the release of bile acid through the bile acid transporter BSEP as well as several other proteins involved and can counteract a bile congestion of different origins.
use
- Dissolution of small cholesterol gallstones: The prerequisite is that the gallbladder is still functional and that the gallstones are small and X-ray negative (no shadowing in the X-ray image ).
- Primary biliary cholangitis and its preforms
- Primary sclerosing cholangitis : Here UDCA is used for symptomatic therapy and to prevent complications (especially the development of colon cancer ). An influence on the course of the disease has not been proven.
- Whether its use in other chronic liver diseases, such as liver cirrhosis, is promising has not yet been finally clarified.
- Intrahepatic pregnancy cholestasis
Side effects
Puffy stools or diarrhea may occur. Other side effects such as urticaria are rare.
Animal welfare
Due to the skepticism about synthetic active ingredients in Asia, the active ingredient is still often obtained directly from the bile of bears there. The bears are kept on so-called bear farms under excruciating conditions in only life-size cages. With the help of a metal catheter, bile is regularly removed from them with pain . The Animals Asia Foundation is committed to the elimination of bear farming and the use of synthetic substitutes. In 2001, the Chinese Ministry of Health announced that health products made from bear gall powder will no longer be approved in order to protect wildlife and ensure the safety of health products. No such product has been approved by the Ministry of Health since then. Attempts are being made to prevent the trade in material of animal origin with the help of tests with which the bear-specific albumin is detected in an immunoassay .
Trade names
Cholit-Ursan (D), Ursosan (CZ, PL, SK, SI, UA, BA, RU, MN), De-Ursil (CH), UDC (D), Urso (D), Ursochol (D, CH), Ursofalk (D, A, CH)
Lithofalk (D), out of sales since January 1, 2011
literature
- I. Copaci et al: New therapeutic indications of ursodeoxycholic acid. ( Memento of February 14, 2010 in the Internet Archive ) (PDF; 110 kB). In: Rome J Gastroenterol. Volume 14, 2005, pp. 259-266. PMID 16200237 .
Individual evidence
- ↑ Entry on URSODIOL in the CosIng database of the EU Commission, accessed on May 18, 2020.
- ↑ a b c Entry on ursodeoxycholic acid in the ChemIDplus database of the United States National Library of Medicine (NLM) .
- ↑ a b Entry on ursodeoxycholic acid in the GESTIS substance database of the IFA , accessed on January 9, 2019(JavaScript required) .
- ↑ MG Roma, FA Crocenzi, EA Sánchez Pozzi: Hepatocellular transport in acquired cholestasis: new insights into functional, regulatory and therapeutic aspects. In: Clin Sci (Lond). 114 (9), May 2008, pp. 567-588. PMID 18377365
- ^ EJ Heathcote: Management of primary biliary cirrhosis. The American Association for the Study of Liver Diseases practice guidelines. In: Hepatology . 31 (4), Apr 2000, pp. 1005-1013. PMID 10733559
- ↑ U. Leuschner, MP Manns, R. Eisebitt: Ursodeoxycholic acid in the therapy for primary biliary cirrhosis: effects on progression and prognosis. In: Z Gastroenterol. 43 (9), Sep 2005, pp. 1051-1059. PMID 16142614
- ↑ SN Cullen, RW Chapman: The medical management of primary sclerosing cholangitis. In: Semin Liver Dis . 26 (1), Feb 2006, pp. 52-61. PMID 16496233
- ↑ Asia: The bear, the living dispenser. In: Welt Online. 2013, accessed October 17, 2017 .
- ↑ Bile acids: More than just solubilizers. In: Pharmaceutical newspaper online. Retrieved October 17, 2017 .
- ↑ For a handful of bear bile | MDR.DE . ( mdr.de ). mdr.de ( Memento of the original from October 17, 2017 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Bear bile: dilemma of traditional medicinal use and animal protection . In: Journal of Ethnobiology and Ethnomedicine . tape 5 , 2009, p. 2 , doi : 10.1186 / 1746-4269-5-2 , PMID 19138420 , PMC 2630947 (free full text).
