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World J Gastroenterol. Feb 21, 2009; 15(7): 804-816
Published online Feb 21, 2009. doi: 10.3748/wjg.15.804
Bile acids: Chemistry, physiology, and pathophysiology
Maria J Monte, Jose JG Marin, Alvaro Antelo, Jose Vazquez-Tato
Maria J Monte, Jose JG Marin, Laboratory of Experimental Hepatology and Drug Targeting, CIBERehd, University of Salamanca, Salamanca 37007, Spain
Alvaro Antelo, Jose Vazquez-Tato, Facultad de Ciencias, Departamento de Quimica Fisica, Campus of Lugo, University of Santiago, Lugo 27002, Spain
Author contributions: All authors contributed equally to this paper.
Correspondence to: Maria J Monte, Department of Physiology and Pharmacology, Campus Miguel de Unamuno E.I.D. S-09, Salamanca 37007, Spain.
Telephone: +34-923-294674
Fax: +34-923-294669
Received: November 12, 2008
Revised: December 16, 2008
Accepted: December 23, 2008
Published online: February 21, 2009

The family of bile acids includes a group of molecular species of acidic steroids with very peculiar physical-chemical and biological characteristics. They are synthesized by the liver from cholesterol through several complementary pathways that are controlled by mechanisms involving fine-tuning by the levels of certain bile acid species. Although their best-known role is their participation in the digestion and absorption of fat, they also play an important role in several other physiological processes. Thus, genetic abnormalities accounting for alterations in their synthesis, biotransformation and/or transport may result in severe alterations, even leading to lethal situations for which the sole therapeutic option may be liver transplantation. Moreover, the increased levels of bile acids reached during cholestatic liver diseases are known to induce oxidative stress and apoptosis, resulting in damage to the liver parenchyma and, eventually, extrahepatic tissues. When this occurs during pregnancy, the outcome of gestation may be challenged. In contrast, the physical-chemical and biological properties of these compounds have been used as the bases for the development of drugs and as pharmaceutical tools for the delivery of active agents.

Keywords: Cholestasis, Cholesterol, Liver, Metabolism, Transport