| [ Summary ] |
The basis of the pharmacological actions of UDCA on the liver is considered to be related to choleretic effects, UDCA enrichment instead of hydrophobic bile acids, protection of hepatocytes and cholangiocytes and immunomodulatory effects. The intracellular mechanisms of the action of UDCA and protection against bile acid-induced apoptosis of hepatocytes and cholangiocytes have recently been investigated. Several double-blind controlled studies revealed that UDCA at a dosage of 12-15mg/kg/day improves serum liver chemistry, may delay disease progression to cirrhosis, and may prolong transplant-free survival. The limitations of the effects of UDCA may be partly related to overlapping autoimmune hepatitis. The benefits of UDCA on patients with advanced cirrhosis have not been established. Future efforts should focus on elucidation of the molecular mechanisms of the actions of UDCA and on recommendations for treatment of UDCA-resistant cases. |