CONCENTRATION OF UNSULFATED LITHOCHOLIC ACID IN PORTAL AND SYSTEMIC VENOUS PLASMA - EVIDENCE THAT LITHOCHOLIC ACID DOES NOT DOWN-REGULATE THE HEPATIC CHOLESTEROL 7-ALPHA-HYDROXYLASE ACTIVITY IN GALLSTONE PATIENTS

It has been proposed that lithocholic acid may have a physiological ro le for the regulation of bile acid synthesis in humans. In this study, the portal venous concentration and hepatic uptake of unsulfated lith ocholic acid was determined in 21 gallstone patients - untreated, chol estyramine-treated and chenodeoxycholic acid-treated -- at cholecystec tomy. Lithocholic acid was analyzed by a combined gas-liquid mass-frag mentographic technique. In most of the patients a liver biopsy was obt ained for assay of the cholesterol 7 alpha-hydroxylase activity. The p ortal venous concentration of unsulfated lithocholic acid averaged 0.3 2 mu mol/l in untreated patients, constituting about 4% of the total b ile acids. The apparent hepatic uptake of lithocholic acid averaged 78 %, being as high as that of cholic acid. No significant correlation wa s obtained between the portal venous concentration of unsulfated litho cholic acid and the hepatic cholesterol 7 alpha-hydroxylase activity. This study thus confirms an enterohepatic circulation of lithocholic a cid in humans. No evidence was obtained that the portal venous inflow of small amounts of lithocholic acid to the liver is of regulatory imp ortance for the cholesterol 7 alpha-hydroxylase activity.