期刊
EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY
卷 13, 期 2, 页码 157-171出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/17474124.2019.1549988
关键词
Bile acids; gallbladder; lithogenic bile; pathogenesis; primary prevention; cholesterol; FXR; GPBAR-1/TGR5; liver; metabolic syndrome; obesity
资金
- NIAAA NIH HHS [R21 AA025737] Funding Source: Medline
- NIDDK NIH HHS [R01 DK114516] Funding Source: Medline
Introduction: Cholesterol gallstone disease have relationships with various conditions linked with insulin resistance, but also with heart disease, atherosclerosis, and cancer. These associations derive from mechanisms active at a local (i.e. gallbladder, bile) and a systemic level and are involved in inflammation, hormones, nuclear receptors, signaling molecules, epigenetic modulation of gene expression, and gut microbiota. Despite advanced knowledge of these pathways, the available therapeutic options for symptomatic gallstone patients remain limited. Therapy includes oral litholysis by the bile acid ursodeoxycholic acid (UDCA) in a small subgroup of patients at high risk of postdissolution recurrence, or laparoscopic cholecystectomy, which is the therapeutic radical gold standard treatment. Cholecystectomy, however, may not be a neutral event, and potentially generates health problems, including the metabolic syndrome. Areas covered: Several studies on risk factors and pathogenesis of cholesterol gallstone disease, acting at a systemic level have been reviewed through a PubMed search. Authors have focused on primary prevention and novel potential therapeutic strategies. Expert commentary: The ultimate goal appears to target the manageable systemic mechanisms responsible for gallstone occurrence, pointing to primary prevention measures. Changes must target lifestyles, as well as experimenting innovative pharmacological tools in subgroups of patients at high risk of developing gallstones.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据