RATIONALE FOR THERAPY WITH URSODEOXYCHOLIC ACID IN PATIENTS WITH CHOLESTATIC LIVER-DISEASE

Ursodeoxycholic acid is increasingly used in the treatment of a variet y of cholestatic diseases such as primary biliary cirrhosis. The prese nt article summarizes current understanding of the mechanism of action of ursodeoxycholic acid in these diseases. Apart from a direct hepato protective effect, ursodeoxycholic acid also influences the enterohepa tic circulation with decreased ileal reabsorption and increased faecal excretion of potentially hepatotoxic endogenous bile salts. In additi on, a cholehepatic shunt mechanism and immune modulating effects may a lso be important.