[Morphologic studies on the toxicity and therapeutic scope of chenodeoxycholic acid].
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Biomedical subjects
Publications and source records attributed to U Leuschner.
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Since the successful dissolution of cholesterol gallstones is depending to a vast degree on the selection of patients put to test, selection of apt patients was to be the center point of the work session. Furthermore therapy and side effects was being discussed. The best method of choosing patients for chenodeoxycholic-acid-(CDC)-therapy is presented by oral, less by intravenous, cholecystography. Normally this examination provides us with a fair judgement on structure of stones, size of stones and total stone volume, factors which are of considerable importance for any therapeutic success. Determination of the lithogenic index and the finding of cholesterol cristals in the bile could be competent criteria of selection, but these methods are far to complicated. These measurements could only be applied for the determination of the minimal maintenance dosage before onset of long lasting therapy after stone dissolution. The toxic side effects of CDC-therapy seem to be of minor degree in human beings. Changes of liver tissue that could be unequivocally traced back to CDC could not be detected, in contrast to animal experiments, where as there seems to be a correlationbetween an often observed elevation of transaminases and the CDC-dosage applied. There is no negative influence upon fat metabolism of the patient. There were found no morphologic or functional disorders of the gastro-intestinal tract due to CDC-treatment with the exception of chologenic diarrhea. We have still to wait for the results of long-term studies.
The influence of chenodesoxycholic acid on the gastro-intestinal tract of male Wistar rats was studied. Chenodesoxycholic acid was orally administered in a dosis of 20mg/kg body weight over a period of 5, 14, 20, 30 and 60 days. The electron microscope revealed only slight pathological changes compared to the control group of untreated animals. While stomach, duodenum and ascending colon were found to be non-specific, supranuclear fatty deposits were detected in the jejunum; in the terminal ileum and the jejunum swollen microvilli and a loosening of the terminal reticulum was observed.
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