The Bile Acids, Chemistry, Physiology, and Metabolism

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1 Mechanisms of Bile Acid Biosynthesis.- I. Introduction.- II. Formation of Cholic Acid.- A. Changes in Steroid Nucleus.- B. Oxidation of Side Chain.- III. Formation of Chenodeoxycholic Acid.- IV. Formation of Other Primary Bile Acids.- V. Conjugation of Bile Acids.- VI. Regulation of Bile Acid Formation.- VII. Formation of Bile Salts in "Primitive" Animals.- A. Changes in Steroid Nucleus.- B. Oxidation of Side Chain.- References.- 2 Bile Salt Transport Systems.- I. Introduction.- II. Active Transport in the Intestine.- III. Passive Proximal Intestinal Absorption of Bile Salts.- IV. Passive Absorption of Bile Salts in the Lower Gastrointestinal Tract.- V. The Transport of Bile Salts in the Liver.- VI. Renal Transport of Bile Salts.- References.- 3 Bile Salt Metabolism in Man.- I. Introduction.- II. Primary Bile Salts in Man.- III. Pathways for Primary Bile Salt Formation in Man.- IV. Synthesis Rates.- V. Maximum Synthesis Rates.- VI. Relative Synthesis Rates in Liver Disease.- VII. Formation of Secondary Bile Acids in Man.- VIII. Amino Acid Conjugates.- IX. Sulfate Esters.- X. Altered Bile Salt Metabolism with Hepatobiliary Disorders.- XI. Disease Groups.- XII. Portal Cirrhosis.- XIII. Bile Duct Obstruction.- XIV. Hepatitis.- XV. Alcoholic Liver Injury.- XVI. Drug-Induced Jaundice.- XVII. Bile Salts and Pruritus.- XVIII. Pruritus and Pregnancy.- XIX. Lithocholic Acid and Liver Injury.- XX. Dissociated Jaundice.- XXI. Conjugation in Hepatobiliary Disorders.- XXII. Stagnant Loop Syndrome.- XXIII. Bile Salts and Target Cells.- XXIV. Excretion in Urine and Feces.- XXV. Feces.- XXVI. Enteroliths.- XXVII. Therapeutic Agents in Bile Salts.- XXVIII. Anion Exchange Resins.- XXIX. Antibiotics.- References.- 4 Newer Aspects of Bile Salt Metabolism in Intestinal Disease.- I. General Considerations of Experimental Methods Used in These Clinical Investigations.- II. Studies of Enterohepatic Circulation of Bile Salts in Patients with Diseases Primarily Involving the Distal Small Intestine.- A. Quantitative Changes in Recirculating Bile Salts.- B. Qualitative Changes in Recirculating Bile Salts.- III. Studies of Enterohepatic Circulation of Bile Salts in Patients with Diseases Primarily Involving the Proximal Small Intestine.- A. Nontropical Sprue and Whipple's Disease.- B. Altered Intestinal Microflora, "Blind-Loop" Syndrome.- References.- 5 Bile Acids and the Intestinal Absorption of Fat and Electrolytes in Health and Disease.- I. Introduction.- A. Occurrence of Bile Acids in Vertebrates.- B. The Enterohepatic Circulation of Bile Acids.- C. Influence of Conjugation.- D. Bacteria-Bile Acid Relationships.- II. Transport Function of Bile Acids During Fat Digestion and Absorption.- A. Behavior of Individual Lipolytic Products in Water.- B. Behavior of Individual Lipolytic Products in Bile Acid Solutions.- C. Behavior of Mixtures of All Lipolytic Products.- D. Lipid Digestion and Absorption.- E. Other Effects of Bile Acids.- F. Disturbances in Fat Digestion.- G. The Enterohepatic Circulation of Bile Acids.- III. Influence of Bile Acids on Water and Electrolyte Transport in the Intestinal Tract 147.- A. The Stomach.- B. The Small Intestine.- C. The Large Intestine.- References.- 6 Experimental Cholelithiasis.- I. Introduction.- A. Background.- B. Composition of Human Gallstones.- C. Stages in Gallstone Formation.- II. Stasis and Infection.- A. History.- B. Pathophysiology.- III. Cholesterol Stones.- A. Hamsters.- B. Mice.- C. Rabbits.- D. Guinea Pigs.- E. Dogs.- F. Miscellaneous.- IV. Calcium Stones.- A. Carbonate and Bilirubinate Stones.- B. Cholanate Stones.- V. Vitamin A Deficiency.- VI. Conclusions.- References.- 7 Clinical Implications of Bile Acid Metabolism in Man.- I. Introduction.- II. Synthesis of Primary Bile Acids.- III. Enterohepatic Circulation of Bile Acids.- IV. Quantitation of Bile Acid Metabolism.- A. Determination of Fecal Bile Acids.- B. Fecal Excretion of Administered Isotopic Bile Acids.- C. Isotope Dilution.- D. Measurement of Bile Acid Pool.- V. Physiological Functions of Bile Acids.- A. Effects on Biliary Secretion.- B. Catabolism of Cholesterol via Bile Acids.- C. Role in Lipid Absorption.- D. Role in Water Absorption.- VI. Bile Salt Metabolism in Physiological Conditions.- A. Age.- B. Body Size.- C. Sex.- D. Obesity.- E. Diet.- VII. Bile Salt Metabolism in Clinical Conditions.- A. Hyperlipidemia.- B. Endocrinological Factors.- C. Liver Diseases.- D. Pancreatic Diseases.- E. Gastrointestinal Tract.- VIII. Drugs Affecting Bile Acid Excretion.- References.- 8 Effect of Hormones on Bile Acid Metabolism.- I. Introduction.- II. Thyroid Hormones.- III. Pituitary Hormones.- IV. Gonadal Hormones.- V. Adrenal Hormones.- VI. Conclusion.- References.- 9 Enzymes in Bile Acid Metabolism.- I. Introduction.- II. Formation of the Peptide Bond of Conjugated Bile Acids.- A. Properties of the Enzyme System.- B. Assay of Bile Acid Conjugating Activity in Human Liver Homogenates.- C. Characteristics of the Peptide-Bond Synthesizing Systems.- D. Factors That Determine Bile Acid Conjugation.- III. Peptide Bond Hydrolases of Bile Acid Conjugates.- A. Cultivation of C. perfringens.- B. Characteristics of Clostridial Cholylglycine Hydrolase.- C. Assay of Cholylglycine Hydrolase Activity.- D. Relationship of Substrate Structure to Enzyme Activity.- E. Bile Salt Hydrolases of Other Bacterial Genera.- IV. Hydroxysteroid Oxidoreductases and Related Enzymes.- A. Oxidoreductases Acting on 3-Hydroxy/3-Ketocholanoic Acids.- B. Miscellaneous Oxidoreductases and Dehydroxylases.- V. Conclusion.- References.- 10 Action of Hypolipidemic Drugs on Bile Acid Metabolism.- I. Introduction.- II. Nicotinic Acid.- III. Neomycin.- IV. Ethyl p-Chlorophenoxyisobutyrate (Clofibrate, Atromid-S).- V. Cholestyramine.- VI. Other Compounds.- VII. Mitochondrial Oxidation of Cholesterol.- VIII. Conclusion.- References.- 11 Bile Acid Metabolism in Gnotobiotic Animals.- I. Introduction.- A. Definitions.- B. Antibiotic Experiments with Conventional Animals.- C. Cholesterol Feeding and Liver and Serum Cholesterol Levels of Germfree and Conventional Animals.- II. Studies of Cholesterol Catabolism to Bile Acids in Germfree Animals.- A. Fate of 14C-26 of Cholesterol Molecule.- B. Release of Radioactive 14CO2 in Germfree and Conventional Animals.- III. Bile Acid Pool Sizes, Turnover Rates, and Physiological Observations in Germfree versus Conventional Animals.- IV. State of Bile Acids in the Intestinal Lumen.- V. Quantitative Fecal Excretion of Bile Acids by Germfree and Conventional Animals.- A. Rats.- B. Chickens.- C. Swine.- D. Rabbits.- VI. Qualitative Changes in Bile Acids as a Result of Microbiological Interaction.- A. Types of Studies.- B. Observations in Gnotobiotic Animals.- C. Changes Caused by Microbiological Species in In Vitro Experiments.- VII. Conclusions.- References.- Note Added in Proof.- Author Index.