2008, Número 41
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Med Univer 2008; 10 (41)
Inhibición de la absorción intestinal de colesterol. Una nueva estrategia para el tratamiento médico de la litiasis biliar de colesterol
Méndez SN, Uribe M
Idioma: Español
Referencias bibliográficas: 27
Paginas: 230-234
Archivo PDF: 396.76 Kb.
RESUMEN
La litiasis biliar o colelitiasis es muy frecuente en los continentes Americano y Europeo. En los países de esos continentes la litiasis biliar puede representar un problema de salud pública debido la morbilidad que induce. Los cálculos biliares de colesterol son los más frecuentes en México y en países de occidente. Su fisiopatología es multifactorial, pero uno de los factores de riesgo más importantes es la dieta rica en colesterol, la cual puede inducir bilis litogénica. El ezetimibe inhibe la absorción de colesterol de la dieta a nivel intestinal. En esta breve revisión abordaremos los mecanismos de producción de bilis litogénica y su inhibición mediante ezetimibe, la cual puede ser considerada como una nueva estrategia para tratar y prevenir la litiasis biliar de colesterol.
REFERENCIAS (EN ESTE ARTÍCULO)
Lammert F, Miquel JF. Gallstone disease: from genes to evidence-based therapy. J Hepatol 2008;48(Suppl. 1):S124-35.
Méndez-Sánchez N, Ponciano-Rodríguez G, Jessurun J, Alonso de Ruiz P, Romero AP, Uribe M. Galllstone composition in Mexican patients. Arch Med Res 1995;26:415-9.
Hofmann AF. Biliary secretion and excretion in health and disease: current concepts. Ann Hepatol 2007;6:15-27.
Méndez-Sánchez N. Tratamiento médico de la enfermedad hepática colestásica. En: Yamamoto K, López E, Sánchez Avila JF, Uribe M, editores. Gastroenterología, hepatología y endoscopia basada en la evidencia. 1ª ed. México: Fundación Mexicana para la Salud, 2008;pp:259-69.
Méndez-Sánchez N, Chavez-Tapia NC, Uribe M. New molecular features of cholestatic diseases of the liver. Rev Invest Clin 2003;55:546-56.
Schwartz CC, Halloran LG, Vlahcevic ZR, Gregory DH, Swell L. Preferential utilization of free cholesterol from high-density lipoproteins for biliary cholesterol secretion in man. Science 1978;200:62-4.
Schwartz CC, Vlahcevic ZR, Halloran LG, Gregory DH, Meek JB, Swell L. Evidence for the existence of definitive hepatic cholesterol precursor compartments for bile acids and biliary cholesterol in man. Gastroenterology 1975;69:1379-82.
Empen K, Lange K, Stange EF, Scheibner J. Newly synthesized cholesterol in human bile and plasma: quantization by mass isotopomer distribution analysis. Am J Physiol 1997;272(2 Pt 1):G367-73.
Wang DQ-H, Carey MC. Measurement of intestinal cholesterol absorption by plasma and fecal dual-isotope ratio, mass balance, and lymph fistula methods in the mouse: an analysis of direct versus indirect methodologies. J Lipid Res 2003;44:1042-59.
Wang DQH, Paigen B, Carey MC. Genetic factors at the enterocyte level account for variations in intestinal cholesterol absorption efficiency among inbred strains of mice. J Lipid Res 2001;42:1820-30.
Hofmann AF, Borgström B. Physico-chemical state of lipids in intestinal content during their digestion and absorption. Gastroenterology 1963;21:43-50.
Hofmann AF, Borgström B. The intraluminal phase of fat digestion in man: the lipid content of the micellar and oil phases of intestinal content obtained during fat digestion and absorption. J Clin Invest 1964;43:247-57.
Eckhardt ER, Wang DQH, Donovan JM, Carey MC. Dietary sphingomyelin suppresses intestinal cholesterol absorption by decreasing thermodynamic activity of cholesterol monomers. Gastroenterology 2002;122:948-56.
Rosenblum SB, Huynh T, Davis HR, Yumibe N, et al. Discovery of 1-(4-fluorophenyl)-(3R)-[3-(4-fluorophenyl)-(3S)-hydroxypropyl]-(4S)-(4-hydroxyphenyl)-2-azetidinone (SCH 58235): a designed, potent, orally active inhibitor of cholesterol absorption. J Med Chem 1998;41:973-80.
Van Heek M, France CF, Compton DS, McLeod RL, et al. In vivo metabolism-based discovery of a potent cholesterol absorption inhibitor, SCH58235, in the rat and rhesus monkey through the identification of the active metabolites of SCH48461. J Pharmacol Exp Ther 1997;283:157-63.
Bays HE, Moore PB, Drehobl MA, Rosenblatt S, Ezetimibe Study Group. Effectiveness and tolerability of ezetimibe in patients with primary hypercholesterolemia: pooled analysis of two phase II studies. Clin Ther 2001;23:1209-30.
van Heek M, Farley C, Compton DS, Hoos L, et al. Comparison of the activity and disposition of the novel cholesterol absorption inhibitor, SCH58235, and its glucuronide, SCH60663. Br J Pharmacol 2000;129:1748-54.
Temel RE, Tang W, Ma Y. Hepatic Niemann–Pick C1-like 1 regulates biliary cholesterol concentration and is a target of ezetimibe. J Clin Invest 2007;117:1968-78.
Lamont JT, Carey MC. Cholesterol gallstone formation. Pathobiology and pathomechanics. Prog Liver Dis 1992;10:165-91.
Wang HH, Afdhal NH, Wang DQH. Overexpression of estrogen receptor increases hepatic cholesterogenesis, leading to biliary hypersecretion in mice. J Lipid Res 2006;47:778-86.
Turley SD, Dietschy JM. The contribution of newly synthesized cholesterol to biliary cholesterol in the rat. J Biol Chem 1981;256:2438-46.
Wang DQH, Zhang L, Wang HH. High cholesterol absorption efficiency and rapid biliary secretion of chylomicron remnant cholesterol enhance cholelithogenesis in gallstone-susceptible mice. Biochim Biophys Acta 2005;1733:90-9.
Diehl AK. Epidemiology and natural history of gallstone disease. Gastroenterol Clin North Am 1991;20:1-19.
Mendez-Sanchez N, Zamora-Valdes D, Chavez-Tapia NC, Uribe M. Role of diet in cholesterol gallstone formation. Clin Chim Acta 2007;376:1-8.
Mathur A, Walker JJ, Al-Azzawi HH, Lu D, et al. Ezetimibe ameliorates cholecystosteatosis. Surgery 2007;142:228-33.
Zuñiga S, Molina H, Azocar L. Ezetimibe prevents cholesterol gallstone formation in mice. Liver Int 2008;28:935-47.
Wang HH, Portincasa P, Mendez-Sanchez N, Uribe M, Wang DQ. Effect of ezetimibe on the prevention and dissolution of cholesterol gallstones. Gastroenterology 2008;134:2101-10.