RESUMEN
The present work evaluated how a native pea protein isolate (PPI) affects the key roles carried out by bile salts (BS) in lipid digestion by means of the in vitro static INFOGEST protocol. Two gastric residence times were evaluated (10 and 60 min), and then the peptides obtained (GPPP) were mixed with BS at physiological concentration in simulated intestinal fluid to understand how they interact with BS both at the bulk and at the interface. Both GPPP give rise to a film with a predominant viscous character that does not constitute a barrier to the penetration of BS, but interact with BS in the bulk duodenal fluid. When the peptides flushing from the stomach after the different gastric residence times undergo duodenal digestion, it was found that for the longer gastric residence time the percentage of soluble fraction in the duodenal phase, that perform synergistically with BS micelles, was twice that of the lower residence time, leading to an increase in the solubilization of oleic acid. These results finally lead to a greater extent of lipolysis of olive oil emulsions. This work demonstrates the usefulness of in vitro models as a starting point to study the influence of gastric residence time of pea protein on its interaction with BS, affecting lipolysis. Pea proteins were shown to be effective emulsifiers that synergistically perform with BS improving the release and bioaccessibility of bioactive lipids as olive oil.
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Ácidos y Sales Biliares , Digestión , Lipólisis , Proteínas de Guisantes , Ácidos y Sales Biliares/metabolismo , Ácidos y Sales Biliares/química , Proteínas de Guisantes/química , Proteínas de Guisantes/metabolismo , Pisum sativum/química , Pisum sativum/metabolismo , Péptidos/metabolismo , Péptidos/química , Duodeno/metabolismo , HumanosRESUMEN
There are massive sources of lactic acid bacteria (LAB) in traditional dairy products. Some of these indigenous strains could be novel probiotics with applications in human health and supply the growing needs of the probiotic industry. In this work, were analyzed the probiotic and technological properties of three Lactobacilli strains isolated from traditional Brazilian cheeses. In vitro tests showed that the three strains are safe and have probiotic features. They presented antimicrobial activity against pathogenic bacteria, auto-aggregation values around 60%, high biofilm formation properties, and a survivor of more than 65% to simulated acid conditions and more than 100% to bile salts. The three strains were used as adjunct cultures separately in a pilot-scale production of Prato cheese. After 45 days of ripening, the lactobacilli counts in the cheeses were close to 8 Log CFU/g, and was observed a reduction in the lactococci counts (around -3 Log CFU/g) in a strain-dependent manner. Cheese primary and secondary proteolysis were unaffected by the probiotic candidates during the ripening, and the strains showed no lipolytic effect, as no changes in the fatty acid profile of cheeses were observed. Thus, our findings suggest that the three strains evaluated have probiotic properties and have potential as adjunct non-starter lactic acid bacteria (NSLAB) to improve the quality and functionality of short-aged cheeses.
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Queso , Probióticos , Queso/microbiología , Brasil , Microbiología de Alimentos , Lactobacillus/metabolismo , Lactobacillus/fisiología , Lactobacillales/fisiología , Lactobacillales/aislamiento & purificación , Lactobacillales/metabolismo , Lactobacillales/clasificación , Biopelículas/crecimiento & desarrollo , Ácidos Grasos/metabolismo , Fermentación , Ácidos y Sales Biliares/metabolismoRESUMEN
SCOPE: To analyze the effects of fexaramine (FEX), as an intestinal FXR agonist, on the modulation of the intestinal microbiota and ileum of mice fed a high-fat (HF) diet. METHODS AND RESULTS: Three-month-old C57Bl/6 male mice are divided into two groups and received a control (C, 10% of energy from lipids) or HF (50% of energy from lipids) diet for 12 weeks. They are subdivided into the C, C + FEX, HF, and HF + FEX groups. FEX is administered (FEX-5 mg kg-1 ) via orogastric gavage for three weeks. Body mass (BM), glucose metabolism, qPCR 16S rRNA gene expression, and ileum gene expression, bile acids (BAs), tight junctions (TJs), and incretin are analyzed. FEX reduces BM and glucose intolerance, reduces plasma lipid concentrations and the Firmicutes/Bacteroidetes ratio, increases the Lactobacillus sp. and Prevotella sp. abundance, and reduces the Escherichia coli abundance. Consequently, the ileal gene expression of Fxr-Fgf15, Tgr5-Glp1, and Cldn-Ocldn-Zo1 is increased, and Tlr4-Il6-Il1beta is decreased. CONCLUSION: FEX stimulates intestinal FXR and improves dysbiosis, intestinal TJs, and the release of incretins, mitigating glucose intolerance and BM increases induced by an HF diet. However, FEX results in glucose intolerance, insulin resistance, and reduces intestinal TJs in a control group, thus demonstrating limitations to this dietary model.
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Intolerancia a la Glucosa , Ratones , Masculino , Animales , Intolerancia a la Glucosa/tratamiento farmacológico , Dieta Alta en Grasa/efectos adversos , Disbiosis/tratamiento farmacológico , ARN Ribosómico 16S , Uniones Estrechas , Inflamación/tratamiento farmacológico , Lípidos , Ratones Endogámicos C57BL , Ácidos y Sales BiliaresRESUMEN
Amaranth is a dicotyledonous plant, now considered a health-promoting food. It has been rediscovered by the worldwide food industry, which is increasingly becoming aware of the many uses and benefits provided by amaranth in various food preparations. Amaranth dietary fibers, soluble and insoluble fractions, obtained from flour, protein isolate, and beverage were physicochemically characterized and their potential bile acid binding capacity was evaluated. Primary bile acids binding to fiber might contribute to a hypocholesterolemic effect, while the binding of secondary bile acids could minimize the cytotoxic effect that these metabolites exert on the colon. Amaranth fiber fractions were capable of sequestering cholate, taurocholate, deoxycholate, and bovine bile, with a percentage depending not only on the origin and the type of amaranth fiber evaluated but also on the bile acid studied. Flour fiber and the protein isolate insoluble fractions were the most efficient for binding bile and bile acids with uptake values between 29 and 100% relative to cholestyramine. Moreover, deoxycholate, a hydrophobic secondary bile acid, was the most captured by all the fractions, reaching 100% uptake with total and insoluble fibers of the three amaranth products. These results would suggest that the main effect through which amaranth fiber binds bile acids corresponds to an adsorptive effect mediated by hydrophobic interactions.
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Ácidos y Sales Biliares , Fibras de la Dieta , Animales , Bovinos , Fibras de la Dieta/análisis , Ácido Taurocólico , Ácido DesoxicólicoRESUMEN
Ursodeoxycholic acid (UDCA) is a natural substance physiologically produced in the liver. Initially used to dissolve gallstones, it is now successfully used in treating primary biliary cirrhosis and as adjuvant therapy for various hepatobiliary cholestatic diseases. However, the mechanisms underlying its beneficial effects still need to be clarified. Evidence suggests three mechanisms of action for UDCA that could benefit humans with cholestatic liver disease (CLD): protection of cholangiocytes against hydrophobic bile acid (BA) cytotoxicity, stimulation of hepatobiliary excretion, and protection of hepatocytes against BA-induced apoptosis. These mechanisms may act individually or together to potentiate them. At the molecular level, it has been observed that UDCA can generate modifications in the transcription and translation of proteins essential in the transport of BA, correcting the deficit in BA secretion in CLD, in addition to activating signaling pathways to translocate these transporters to the sites where they should fulfill their function. Inhibition of BA-induced hepatocyte apoptosis may play a role in CLD, characterized by BA retention in the hepatocyte. Thus, different mechanisms of action contribute to the improvement after UDCA administration in CLD. On the other hand, the effects of UDCA on tissues that possess receptors that may interact with BAs in pathological contexts, such as skeletal muscle, are still unclear. This work aims to describe the main molecular mechanisms by which UDCA acts in the human body, emphasizing the interaction in tissues other than the liver.
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Colestasis , Hepatopatías , Humanos , Ácido Ursodesoxicólico/farmacología , Ácido Ursodesoxicólico/uso terapéutico , Ácido Ursodesoxicólico/metabolismo , Ácidos y Sales Biliares , Colestasis/tratamiento farmacológico , Colestasis/metabolismo , Hepatopatías/tratamiento farmacológicoRESUMEN
BACKGROUND: Bile acids (BAs) are steroid molecules synthesized exclusively in the liver, being end products of cholesterol catabolism. BAs are known to be involved in several metabolic alterations, including metabolic syndrome and type 2 diabetes mellitus (DM2). DM2 is a chronic degenerative disease characterized by insulin resistance, insulin deficiency due to insufficient production of pancreatic ß-cells, and elevated serum glucose levels leading to multiple complications. OBJECTIVE: The objective of this study is to investigate the role of BAs in the pathophysiology of DM2, highlighting the possibilities in the development of therapeutic procedures targeting BAs as an optional pathway in the treatment of DM2. METHODS: The research was carried out through narrative review and publications on the relationship between BAs and DM2. The databases used for the search include PubMed, Scopus, and Web of Science. The keywords used for the search include bile acids, type 2 diabetes mellitus, metabolic syndrome, and metabolic disorders. RESULTS: The studies have reported the involvement of BAs in the pathophysiology of DM2. BAs act as a ligand for the nuclear farnesoid X receptor, regulating glucose metabolism, lipid metabolism, and cellular energy production. Additionally, BAs modulate the production, elimination, and mobilization of BAs through the farnesoid X receptor. BAs also act as a signaling pathway through Takeda G protein-coupled receptor 5, further contributing to metabolic regulation. These findings suggest that targeting BAs may offer a novel therapeutic approach in the treatment of DM2. CONCLUSION: This study highlights the important role of BAs in DM2, specifically through their interactions with key metabolic pathways. Targeting BAs may represent an innovative and effective approach to the treatment of DM2.
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Diabetes Mellitus Tipo 2 , Síndrome Metabólico , Humanos , Ácidos y Sales Biliares , Diabetes Mellitus Tipo 2/etiología , Glucemia , Transducción de SeñalRESUMEN
Metabolomics studies in sickle cell disease (SCD) have been so far limited to tens of samples, owing to technical and experimental limitations. To overcome these limitations, we performed plasma metabolomics analyses on 596 samples from patients with SCD enrolled in the WALK-PHaSST study (clinicaltrials gov. Identifier: NCT00492531). Clinical covariates informed the biological interpretation of metabolomics data, including genotypes (hemoglobin [Hb] SS, hemoglobin SC), history of recent transfusion (HbA%), response to hydroxyurea treatment (fetal Hb%). We investigated metabolic correlates to the degree of intravascular hemolysis, cardiorenal function, as determined by tricuspid regurgitation velocity (TRV), estimated glomerular filtration rate (eGFR), and overall hazard ratio (unadjusted or adjusted by age). Recent transfusion events or hydroxyurea treatment were associated with elevation in plasma-free fatty acids and decreases in acyl-carnitines, urate, kynurenine, indoles, carboxylic acids, and glycine- or taurine-conjugated bile acids. High levels of these metabolites, along with low levels of plasma S1P and L-arginine were identified as top markers of hemolysis, cardiorenal function (TRV, eGFR), and overall hazard ratio. We thus uploaded all omics and clinical data on a novel online portal that we used to identify a potential mechanism of dysregulated red cell S1P synthesis and export as a contributor to the more severe clinical manifestations in patients with the SS genotype compared to SC. In conclusion, plasma metabolic signatures - including low S1P, arginine and elevated kynurenine, acyl-carnitines and bile acids - are associated with clinical manifestation and therapeutic efficacy in SCD patients, suggesting new avenues for metabolic interventions in this patient population.
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Anemia de Células Falciformes , Enfermedad de la Hemoglobina SC , Humanos , Hidroxiurea/uso terapéutico , Quinurenina/uso terapéutico , Anemia de Células Falciformes/complicaciones , Anemia de Células Falciformes/tratamiento farmacológico , Enfermedad de la Hemoglobina SC/complicaciones , Hemólisis , Hemoglobina Falciforme , Ácidos y Sales Biliares/uso terapéuticoRESUMEN
OBJECTIVE: The increased prevalence of childhood metabolic syndrome (MetS) is a public health issue. It has been shown that a dysregulated bile acid (BA) profile could be involved in the development of MetS, in which the gut microbiota could have a significant role in BA levels. This study aimed to evaluate differences in serum BA levels in children with and without MetS and whether these levels were associated with gut microbial composition. METHODS: A total of 100 children aged 10 to 12 years were enrolled in this study, 42 children with MetS (cases) and 58 control participants. Serum BAs were measured by liquid chromatography-tandem mass spectrometry and gut microbiota was determined by 16S ribosomal RNA gene sequencing. RESULTS: Children with MetS showed higher levels of total, secondary, and 12α-hydroxylated BAs, as well as deoxycholic acid, and these were associated with dyslipidemia and insulin resistance markers. Interestingly, total BAs were negatively correlated with gut bacterial diversity (Shannon index: rho = -0.218, p = 0.035), whereas total, 12α-hydroxylated, and secondary BAs, as well as deoxycholic acid, showed negative correlations with genera known for their potential health effects, including Bifidobacterium, Akkermansia, and Faecalibacterium. CONCLUSIONS: This study suggests that childhood MetS is associated with a dysregulated BA pool and that these alterations could influence the abundance of potentially beneficial bacteria, thus contributing to gut microbial dysbiosis.
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Microbioma Gastrointestinal , Síndrome Metabólico , Niño , Humanos , Adolescente , Ácidos y Sales Biliares , Disbiosis , Ácido DesoxicólicoRESUMEN
Muscle atrophy decreases muscle mass with the subsequent loss of muscle function. Among the mechanisms that trigger sarcopenia is mitochondrial dysfunction. Mitochondria, whose primary function is to produce ATP, are dynamic organelles that present the process of formation (mitogenesis) and elimination (mitophagy). Failure of any of these processes contributes to mitochondrial malfunction. Mitogenesis is mainly controlled by Peroxisome proliferator-activated receptor-gamma coactivator-1alpha (PGC-1α), a transcriptional coactivator that regulates the expression of TFAM, which participates in mitogenesis. Mitophagy is a process of selective autophagy. Autophagy corresponds to a degradative pathway of protein complexes and organelles. Liver disease caused sarcopenia and increased bile acids in the blood. We demonstrated that the treatment with cholic (CA) or deoxycholic (DCA) bile acids generates mitochondrial dysfunction and loss of biomass. This work assessed whether CA and DCA alter autophagy and mitogenesis. For this, western blot evaluated the autophagy process by determining the protein levels of the LC3II/LC3I ratio. In addition, we assessed mitogenesis using a luciferase-coupled plasmid reporter for the PGC-1α promoter and the protein levels of TFAM by western blot. Our results indicate that treatment with CA or DCA induces autophagy, represented by an increase in the LC3II/LC3I ratio. In addition, a decreased autophagic flux was observed. On the other hand, when treated with CA or DCA, a decrease in the activity of the PGC-1α promoter was observed. However, the levels of TFAM increased in myotubes incubated with CA and DCA. Our results demonstrate that CA and DCA modulate autophagy ad mitogenesis in C2C12 myotubes.
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Enfermedades Musculares , Sarcopenia , Humanos , Músculo Esquelético/metabolismo , Sarcopenia/patología , Ácidos y Sales Biliares , Fibras Musculares Esqueléticas/metabolismo , Autofagia , Coactivador 1-alfa del Receptor Activado por Proliferadores de Peroxisomas gammaRESUMEN
Chronic liver diseases are a group of pathologies affecting the liver with high prevalence worldwide. Among them, cholestatic chronic liver diseases (CCLD) are characterized by alterations in liver function and increased plasma bile acids. Secondary to liver disease, under cholestasis, is developed sarcopenia, a skeletal muscle dysfunction with decreased muscle mass, strength, and physical function. CCL5/RANTES is a chemokine involved in the immune and inflammatory response. Indeed, CCL5 is a myokine because it is produced by skeletal muscle. Several studies show that bile acids induce CCL5/RANTES expression in liver cells. However, it is unknown if the expression of CCL5/RANTES is changed in the skeletal muscle of mice with cholestatic liver disease. We used a murine model of cholestasis-induced sarcopenia by intake of hepatotoxin 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC diet), in which we detected the mRNA levels for ccl5. We determined that mice fed the DDC diet presented high levels of serum bile acids and developed typical features of sarcopenia. Under these conditions, we detected the ccl5 gene expression in diaphragm muscle showing elevated mRNA levels compared to mice fed with a standard diet (chow diet). Our results collectively suggest an increased ccl5 gene expression in the diaphragm muscle concomitantly with elevated serum bile acids and the development of sarcopenia.
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Colestasis , Hepatopatías , Sarcopenia , Ratones , Animales , Sarcopenia/patología , Diafragma/metabolismo , Diafragma/patología , Regulación hacia Arriba , Quimiocina CCL5/metabolismo , Colestasis/complicaciones , Colestasis/metabolismo , Colestasis/patología , Hígado/metabolismo , Ácidos y Sales Biliares , Hepatopatías/metabolismo , Expresión Génica , Ratones Endogámicos C57BLRESUMEN
INTRODUÇÃO: El síndrome de Alagille es una enfermedad autosómica dominante con expresión variable ocasionada por defectos en la vía de señalización del receptor Notch debido a mutaciones en los genes JAGGED1 (95%) y NOTCH2 (2,5%). Se encuentra clasificada, y reconocida por el Ministerio de Salud de la Nación, como una enfermedad poco frecuente con una incidencia de aproximadamente 1 cada 30.000 recién nacidos vivos.13 Es considerada una enfermedad multisistémica cuyas principales manifestaciones son colestasis crónica, enfermedad cardíaca congénita, embriotoxón posterior, fenotipo facial característico y vértebras en alas de mariposa. Si bien las manifestaciones clínicas son muy variables, la predominante es la colestasis crónica neonata, donde habitualmente co-existen en diferentes grados de severidad: hepatoesplenomegalia, hiperbilirrubinemia conjugada, hipercolesterolemia, hipertrigliceridemia, y concentraciones elevadas de ácidos biliares y enzimas hepáticas. La colestasis suele intensificarse hasta la edad escolar y luego, en algunos niños, mejora o permanece estable. 2 Además, suelen presentar retraso del crecimiento, prurito y xantomas. El prurito se halla entre los más graves debidos a afecciones hepáticas, suele ser invalidante y se presenta a partir del segundo semestre de vida. 4 La evolución hacia una enfermedad hepática progresiva, cirrosis y fallo hepático, con indicación de trasplante hepático, acontece en el 21 a 31% de los casos. En niños menores de cinco años pueden considerarse como predictores de enfermedad hepática sostenida y grave, la presencia de concentraciones mayores de bilirrubina total de 6,5mg/dL, bilirrubina conjugada 4,5 mg/dl y colesterol 520 mg/dl. OBJETIVO: El objetivo del presente informe es evaluar rápidamente los parámetros de eficacia, seguridad, costos y recomendaciones disponibles acerca del empleo de maralixibat para el tratamiento de personas con síndrome de Alagille. MÉTODOS: Se realizó una búsqueda bibliográfica en las principales bases de datos tales como PUBMED, LILACS, BRISA, COCHRANE, SCIELO, EMBASE, TRIPDATABASE como así también en sociedades científicas, agencias reguladoras, financiadores de salud y agencias de evaluación de tecnologías sanitarias. Se priorizó la inclusión de revisiones sistemáticas, ensayos clínicos controlados aleatorizados, evaluación de tecnología sanitaria y guías de práctica clínica de alta calidad metodológica. En PubMed se utilizó la estrategia de búsqueda que se detalla en el Anexo I. La fecha de búsqueda de información fue hasta el 16 de enero de 2023. Para la búsqueda en Pubmed se utilizó la siguiente estrategia de búsqueda: (maralixibat [Supplementary Concept] OR maralixibat [tiab] OR livmarli [tiab]) AND ("Alagille Syndrome" [MESH] OR "Alagille Syndrome" [tiab] OR Arteriohepatic Dysplasia [tiab]). RECOMENDACIONES: No se hallaron recomendaciones referentes al uso de maralixibat en la indicación especificada por parte de las Sociedades Científicas y Agencias de evaluación de tecnologías sanitarias en Argentina y nivel mundial. Actualmente el Instituto Nacional de Salud y Cuidados de Excelencia del Reino Unido (NICE, su sigla del inglés National Institute for Health and Care Excellence) del Reino Unido se encuentra evaluándolo. CONCLUSIONES: La evidencia que sustenta la aprobación de comercialización de maralixibat para el tratamiento del prurito colestásico en personas mayores a 2 meses de edad con síndrome de Alagille, por parte de las agencias regulatorias relevadas, se basa en un ensayo clínico aleatorizado con un diseño de retirada y con un bajo número de pacientes. Este estudio mostraría que la utilización de este fármaco podría mejorar al mediano plazo, el prurito, los niveles de colesterol, de ácidos biliares y mejorar la calidad de vida reportada por los cuidadores respecto al estado basal. Otros estudios sostendrían que esos beneficios se podrían mantener al largo plazo. Si bien al mediano plazo no se observarían interrupciones del tratamiento debido a eventos adversos graves, al largo plazo se ha descripto interrupciones principalmente debido a la aparición de hipertransaminasemia. Su comercialización se encuentra recientemente autorizada en Estados Unidos y Europa para el tratamiento del prurito colestásico en personas mayores a 2 meses de edad con síndrome de Alagille. Las agencias han otorgado la designación de medicamento huérfano y han advertido sobre la estrecha monitorización del hígado, mediante exámenes de laboratorio hepáticos y de vitaminas liposolubles. No se hallaron guías de práctica clínica actualizadas en Argentina y en el Mundo que mencionen la tecnología en la indicación evaluada. No se hallaron evaluaciones económicas publicadas, aunque el costo mensual medio estimado al precio de adquisición de referencia es excesivamente elevado (USD 67.760).
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Humanos , Ácidos y Sales Biliares/antagonistas & inhibidores , Síndrome de Alagille/tratamiento farmacológico , Argentina , Eficacia , Análisis Costo-Beneficio/economíaRESUMEN
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is now considered the most common chronic liver disease worldwide. NAFLD is related to changes in lipid metabolism and is characterized by the increase or accumulation of fat in hepatocytes that may progress to nonalcoholic steatohepatitis (NASH), which leads to the appearance of inflammatory processes. Treatment consists of changes in diet, physical activity, and weight control; however, these disorders represent a health problem and require the development of novel alternatives to treatment and prevention. NAFLD/NASH are strongly associated with other disorders, such as metabolic syndrome (MetS); in fact, NAFLD is considered the hepatic manifestation of MetS. These disorders are related to other components of MetS, including dyslipidemia, which is characterized by an imbalance in blood cholesterol and triglyceride levels. Prebiotics and probiotics benefit from treating and preventing several ailments, including liver diseases. Specifically, in dyslipidemia, NAFLD, and NASH, probiotics play a fundamental role in conducting the biotransformation of primary bile acids into secondary bile acids, which generally have important activity as immunomodulators and metabolism regulators. The mechanisms of action of pre and probiotics involve the activity of bile acid receptors, such as FXR and TGR-5, and the events resulting from their activation. Therefore, prebiotics and probiotics may be reasonable options to prevent and treat metabolic- related liver diseases.
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Dislipidemias , Síndrome Metabólico , Enfermedad del Hígado Graso no Alcohólico , Probióticos , Humanos , Enfermedad del Hígado Graso no Alcohólico/terapia , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Prebióticos , Hígado/metabolismo , Probióticos/uso terapéutico , Síndrome Metabólico/metabolismo , Dislipidemias/tratamiento farmacológico , Dislipidemias/metabolismo , Ácidos y Sales Biliares/metabolismoRESUMEN
La colangitis biliar primaria es una enfermedad hepática autoinmune que conduce a la destrucción progresiva de los conductos biliares intrahepáticos, lo que aumenta el riesgo de desarrollar cirrosis e hipertensión portal. Actualmente, el ácido ursodesoxicólico es el medicamento de primera línea para el tratamiento de esta entidad. Este medicamento desplaza los ácidos biliares hidrofóbicos y aumenta las concentraciones de ácidos biliares hidrofílicos en la bilis, lo cual favorece la integridad de los conductos biliares, adicionalmente, tiene efectos antiinflamatorios y propiedades inmunomo-duladoras y antiapoptóticas. En los últimos 40 años, numerosos ensayos clínicos han respaldado la eficacia clínica del ácido ursodesoxicólico y su seguridad cuando se utiliza en pacientes con colan-gitis biliar primaria. Se realiza una revisión del ácido ursodesoxicólico en el contexto de colangitis biliar primaria, se describe su historia, mecanismos de acción, efectos secundarios y dosificación. Finalmente, se menciona su uso en situaciones especiales como son el embarazo y la lactancia
Primary biliary cholangitis is an autoimmune liver disease that leads to progressive destruction of intrahepatic bile ducts, increasing the risk of developing cirrhosis and portal hypertension. Currently, ursodeoxycholic acid is the first-line drug for the treatment of this condition. This drug displaces hy-drophobic bile acids and increases concentrations of hydrophilic bile acids in the bile, which favors the integrity of the bile ducts, additionally, it has anti-inflammatory effects and immunoprotective and antiapoptotic properties. Over the past 40 years numerous clinical trials have supported the clinical efficacy of ursodeoxycholic acid and its safety when used in patients with primary biliary cholangitis. A review of ursodeoxycholic acid in the context of primary biliary cholangitis is carried out, and its history, mechanisms of action, side effects and dosage are described. Finally, its use in special situations such as pregnancy and lactation are discussed.
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Humanos , Terapéutica , Ácido Ursodesoxicólico , Colangitis , Seguridad , Bilis , Conductos Biliares , Ácidos y Sales Biliares , Hígado , Cirrosis Hepática BiliarRESUMEN
Aging is associated with glucose metabolism disturbances, such as insulin resistance and hyperinsulinemia, which contribute to the increased prevalence of type 2 diabetes (T2D) and its complications in the elderly population. In this sense, some bile acids have emerged as new therapeutic targets to treat TD2, as well as associated metabolic disorders. The taurine conjugated bile acid, tauroursodeoxycholic acid (TUDCA) improves glucose homeostasis in T2D, obesity, and Alzheimer's disease mice model. However, its effects in aged mice have not been explored yet. Here, we evaluated the actions of TUDCA upon glucose-insulin homeostasis in aged C57BL/6 male mice (18-month-old) treated with 300 mg/kg of TUDCA or its vehicle. TUDCA attenuated hyperinsulinemia and improved glucose homeostasis in aged mice, by enhancing liver insulin-degrading enzyme (IDE) expression and insulin clearance. Furthermore, the improvement in glucose-insulin homeostasis in these mice was accompanied by a reduction in adiposity, associated with adipocyte hypertrophy, and lipids accumulation in the liver. TUDCA-treated aged mice also displayed increased energy expenditure and metabolic flexibility, as well as a better cognitive ability. Taken together, our data highlight TUDCA as an interesting target for the attenuation of age-related hyperinsulinemia and its deleterious effects on metabolism.
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Diabetes Mellitus Tipo 2 , Hiperinsulinismo , Anciano , Ratones , Masculino , Humanos , Animales , Ácidos y Sales Biliares , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Ratones Endogámicos C57BL , Hiperinsulinismo/tratamiento farmacológico , Ácido Tauroquenodesoxicólico/farmacología , Ácido Tauroquenodesoxicólico/uso terapéutico , Insulina/metabolismo , Obesidad/tratamiento farmacológico , Glucosa/metabolismoRESUMEN
INTRODUCTION: Bile acids are signaling molecules with immune, metabolic and intestinal microbiota control actions. In high serum concentrations they increase inflammatory response from the liver-gut axis, until causing multiorgan failure and death; therefore, they may be associated with COVID-19's clinical progression, as a consequence of tissue and metabolic damage caused by SARS-CoV-2. While this topic is of considerable clinical interest, to our knowledge, it has not been studied in Cuba. OBJECTIVE: Study and preliminarily characterize patients admitted with a diagnosis of COVID-19 and high levels of serum bile acids. METHODS: A preliminary exploratory study was carried out with descriptive statistical techniques in 28 COVID-19 patients (17 women, 11 men; aged 19-92 years) who exhibited high levels of serum bile acids (≥10.1 µmol/L) on admission to the Dr. Luis Díaz Soto Central Military Hospital in Havana, Cuba, from September through November 2021. RESULTS: On admission patients presented hypocholesterolemia (13/28; 46.4%), hyperglycemia (12/28; 43.0%) and hyper gamma-glutamyl transpeptidase (23/28; 84.2%). Median blood glucose (5.8 mmol/L) and cholesterol (4.1 mmol/L) were within normal ranges (3.2â6.2 mmol/L and 3.9â5.2 mmol/L, respectively). Severe or critical stage was the most frequent (13/28) and median serum bile acids (31.6 µmol/L) and gamma-glutamyl transferase (108.6 U/L) averaged well above their respective normal ranges (serum bile acids: 0â10 µmol/L; GGT: 9â36 U/L). Arterial hypertension was the most frequent comorbidity (19/28; 67.9%). CONCLUSIONS: Severe or critical stage predominated, with serum bile acids and gamma-glutamyl transferase blood levels above normal ranges. The study suggests that serum bile acid is toxic at levels ≥10.1 µmol/L, and at such levels is involved in the inflammatory process and in progression to severe and critical clinical stages of the disease. In turn, this indicates the importance of monitoring bile acid homeostasis in hospitalized COVID-19 patients and including control of its toxicity in treatment protocols.
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Ácidos y Sales Biliares , COVID-19 , Femenino , Humanos , Masculino , Ácidos y Sales Biliares/sangre , COVID-19/sangre , COVID-19/diagnóstico , Cuba/epidemiología , Hospitales , SARS-CoV-2 , Transferasas , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más AñosRESUMEN
Antibiotic bacterial resistant is a huge concern worldwide and probiotics offer an alternative to mitigate it. This study explores Cystobasidium benthicum LR192 as possible probiotic through microbiological and immunological analyses in mouse model. C. benthicum LR192 was isolated from lichens in a hyperarid environment in Baja California Sur, Mexico. First, microbiological analysis was assessed using 1 × 105 CFU/mL in YM broth: resistance to 1% of bile salts and pH of 2, 3 and 5 (control). Then, yeast capacity to adhere onto the intestinal mucosa and safety to mouse splenocytes were tested. Finally, immunological parameters (phagocytic ability, respiratory burst and myeloperoxidase activities, nitric oxide and IgG production) and immune-associated gene expression (IL-1ß, IL-6 and INF-γ) were determined in daily supplemented mice with the yeast (1 × 108 CFU) at days 10 and 15. The results indicate that C. benthicum LR192 has medium resistance to bile salts and low pH, can adhere to the intestine and did not cause cytotoxicity in splenocytes. Immune parameters and immune-related gene expression indicated immunomodulation at day 10 and 15, specially in leucocytes challenged with Escherichia coli. In conclusion, C. benthicum LR192 showed safe potential probiotic properties, but further studies should be performed to confirm it as a probiotic prospect for humans.
Asunto(s)
Probióticos , Saccharomyces cerevisiae , Humanos , Ratones , Animales , México , Ácidos y Sales Biliares , Escherichia coliRESUMEN
In the last few decades, there has been a growing interest in understanding the mechanisms involved in lipid digestion with the purpose of developing strategies to control this complex physiological process. Bile salts (BS) are natural bio-surfactants that play crucial functions in this process and may represent a key strategy to modulate the lipolysis. One of the main functions is the removal of lipolysis products present at the interface of lipid droplets by solubilizing them in BS micelles, thus avoiding the reaction inhibition. However, there are few studies that analyzed the effects that could have the emulsion components on the solubilization capacity of BS micelles. Thus, the main purpose of the present work was to evaluate the impact of a typical food emulsifier (Tween 80) on the fatty acid (FA) solubilization capacity of BS micelles by using a method recently developed, involving a combination of turbidity and dynamic light scattering (DLS) determinations. As FA solubilization into BS micelles may strongly affect the kinetics of lipolysis, the lipolysis of T80-stabilized oil-in-water (O/W) emulsions was also studied. The results showed that a higher concentration of the emulsifier in the duodenal medium causes the lipolysis rate to be maximum for a longer time. The mechanism involved could be the contribution of T80 to increase the solubilization of FA (and possibly other products of the lipolysis) in the duodenal medium, consequently affecting the potential bioavailability of fatty acids.
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Lipólisis , Micelas , Ácidos y Sales Biliares , Emulsionantes/farmacología , Emulsiones , Ácidos Grasos , Ácido Oléico , Polisorbatos , AguaRESUMEN
Nonalcoholic fatty liver disease (NAFLD), often associated with obesity, is becoming one of the most common liver diseases worldwide. It is estimated to affect one billion individuals and may be present in approximately 25% of the population globally. NAFLD is viewed as a hepatic manifestation of metabolic syndrome, with humans and animal models presenting dyslipidemia, hypertension, and diabetes. The gut-liver axis has been considered the main pathogenesis branch for NAFLD development. Considering that foods or beverages could modulate the gastrointestinal tract, immune system, energy homeostasis regulation, and even the gut-liver axis, we conducted an exploratory study to analyze the effects of kombucha probiotic on hepatic steatosis, glucose tolerance, and hepatic enzymes involved in carbohydrate and fat metabolism using a pre-clinical model. The diet-induced obese mice presented glucose intolerance, hyperinsulinemia, hepatic steatosis, increased collagen fiber deposition in liver vascular spaces, and upregulated TNF-alpha and SREBP-1 gene expression. Mice receiving the kombucha supplement displayed improved glucose tolerance, reduced hyperinsulinemia, decreased citrate synthase and phosphofructokinase-1 enzyme activities, downregulated G-protein-coupled bile acid receptor, also known as TGR5, and farnesol X receptor gene expression, and attenuated steatosis and hepatic collagen fiber deposition. The improvement in glucose tolerance was accompanied by the recovery of acute insulin-induced liver AKT serine phosphorylation. Thus, it is possible to conclude that this probiotic drink has a beneficial effect in reducing the metabolic alterations associated with diet-induced obesity. This probiotic beverage deserves an extension of studies to confirm or refute its potentially beneficial effects.
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Resistencia a la Insulina , Té de Kombucha , Enfermedad del Hígado Graso no Alcohólico , Humanos , Ratones , Animales , Ratones Obesos , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Proteína 1 de Unión a los Elementos Reguladores de Esteroles/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Citrato (si)-Sintasa/metabolismo , Farnesol/metabolismo , Farnesol/farmacología , Proteínas Proto-Oncogénicas c-akt/metabolismo , Hígado , Obesidad/complicaciones , Obesidad/tratamiento farmacológico , Obesidad/metabolismo , Insulina/metabolismo , Glucosa/metabolismo , Ácidos y Sales Biliares/metabolismo , Carbohidratos/farmacología , Serina/metabolismo , Serina/farmacología , Fosfofructoquinasa-1/metabolismo , Proteínas de Unión al GTP/metabolismo , Colágeno/metabolismo , Ratones Endogámicos C57BL , Dieta Alta en GrasaRESUMEN
Fecal microbiota transplantation (FMT) is a successful method for treating recurrent Clostridioides difficile (C. difficile) infection (rCDI) with around 90% efficacy. Due to the relative simplicity of this approach, it is being widely used and currently, thousands of patients have been treated with FMT worldwide. Nonetheless, the mechanisms underlying its effects are just beginning to be understood. Data indicate that FMT effectiveness is due to a combination of microbiological direct mechanisms against C. difficile, but also through indirect mechanisms including the production of microbiota-derived metabolites as secondary bile acids and short chain fatty acids. Moreover, the modulation of the strong inflammatory response triggered by C. difficile after FMT seems to rely on a pivotal role of regulatory T cells, which would be responsible for the reduction of several cells and soluble inflammatory mediators, ensuing normalization of the intestinal mucosal immune system. In this minireview, we analyze recent advances in these immunological aspects associated with the efficacy of FMT.