Медицинский совет (May 2020)
Ursodeoxycholic acid and its unexpected application areas
Abstract
Introduction. Ursodeoxycholic acid (UDCA) came into modern medicine in the 1970s as a potential solvent for small gallstones. But as early as the 1980s, there were clinical studies to improve biochemical indices when using UDCA in other liver diseases. These studies initiated a worldwide active study of the clinical possibilities and various therapeutic effects of UDCA in various diseases, including those beyond the liver. Today, worldwide, UDCA drugs are the lifelong basis for the treatment of primary sclerosing cholangitis (PSC). It is indicated for all types of hepatitis: infectious, toxic, drug-induced, autoimmune and others. It can be stated that the history of study and introduction of UDCA drugs in medicine is the history of the expansion of its application areas, which continues to this day. The purpose of the review is to present the results of the use of UDCA drugs outside the traditional circle of cholestatic liver diseases, the causes and possibilities of their use in other areas of medicine.Main principles. It has been shown that UDCA, originally designed for the treatment of cholestatic liver diseases, along with the known antioxidant, antifibrotic and immunomodulatory effects has a proven fundamental apoptosis regulatory effect. This allows it to have as a possible therapeutic target a whole range of extrahepatic diseases, such as gastrointestinal lesions (IBD, clostridi-osis, radiation and medical intestinal lesions, etc.), diseases of the cardiovascular system, neurodegenerative diseases (Alzheimer’s disease, Parkinson’s disease, ALS), prion diseases (Kuru, Creutzfeldt-Jakob disease) and a number of others.Conclusion. According to modern views, UDCA can be considered as a unique drug of universal cytoprotective action, the expansion of its therapeutic possibilities is promising and is subject to further multilateral study.
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