Bile salts, effect

Chijiiwa, K., and Linscheer, W. G. (1987). Distribution and monomer activity of cholesterol in micellular bile salt Effect of cholesterol level. Am. J. Physiol. 252, G309-G314. 

The mechanism by which sucralfate accelerates healing of duodenal ulcers has not been determined. It does not have significant antisecretory, acid neutralizing activity or direct stimulation of ulcer healing. It is known that the mechanism is local rather than systemic. Binding of pepsin or bile salts may contribute to its effect. It is indicated for the short-term therapy of active duodenal ulcers and for maintenance at reduced dosage. 

FIGURE 25.41 Cholic acid, a bile salt, is synthesized from cholesterol via 7o -hydroxy-cholesterol. Conjugation with taurine or glycine produces taurocholic acid and glycocholic acid, respectively. Taurocholate and glycocholate are freely water-soluble and are highly effective detergents. 

Because they contain both nonpolar and polar domains, these bile salt conjugates are highly effective as detergents. These substances are made in the liver, stored in the gallbladder, and secreted as needed into the intestines. 

The risk of colon cancer appears to be inversely related to calcium and folate intake. Calciums protective effect may be related to a reduction in mucosal cell proliferation rates or through its binding to bile salts in the intestine, whereas dietary folate helps in maintaining normal bowel mucosa. Additional micronutrient deficiencies have been demonstrated through several studies to increase colorectal cancer risk and include selenium, vitamin C, vitamin D, vitamin E, and 3-carotene however, the benefit of dietary supplementation does not appear to be substantial.11... 

Figure 7.51 Effect of bile salt on permeability in donor well at pH 6.5.

An alternative method to overcome the solubility problem mentioned in the last section is to use bile salts to solubilize lipophilic molecules in the donor wells. Figure 7.51 shows a plot of relative permeability (Pe without bildPe with bile) versus membrane retention, which is related to lipophilicity (Section 7.7.2). As the plot shows, the most lipophilic molecules (carvedilol, propranolol, and verapamil) have attenuated permeabilities (by a factor of 3 in the case of carvedilol). The effective partition coefficient between the PAMPA membrane phase and the aqueous phase containing bile salt micelles [577] is expected to be lower for lipophilic molecules, which should result in lower Pe values. This is evident in the figure. 

Penetration enhancers are low molecular weight compounds that can increase the absorption of poorly absorbed hydrophilic drugs such as peptides and proteins from the nasal, buccal, oral, rectal, and vaginal routes of administration [186], Chelators, bile salts, surfactants, and fatty acids are some examples of penetration enhancers that have been widely tested [186], The precise mechanisms by which these enhancers increase drug penetration are largely unknown. Bile salts, for instance, have been shown to increase the transport of lipophilic cholesterol [187] as well as the pore size of the epithelium [188], indicating enhancement in both transcellular and paracellular transport. Bile salts are known to break down mucus [189], form micelles [190], extract membrane proteins [191], and chelate ions [192], While breakdown of mucus, formation of micelles, and lipid extraction may have contributed predominantly to the bile salt-induced enhancement of transcellular transport, chelation of ions possibly accounts for their effect on the paracellular pathway. In addition to their lack of specificity in enhancing mem-... 

Morimoto et al. [33] demonstrated that the ocular absorption of hydrophilic compounds over a wide range of molecular weights could be increased by 2 and 10 mM sodium taurocholate and sodium taurodeoxycholate in a dose-dependent manner. The compounds were glutathione (307 Da), 6-carboxyfluorescein (376 Da), FTTC-dextran (4 kDa), and insulin (5.7 kDa). Of the two bile salts, sodium taurodeoxycholate was more effective. At 10 mM, this bile salt increased the permeability of 6-carboxyfluorescein from 0.02% to 11%, glutathione from 0.08% to 6%, FITC-dextran from 0% to 0.07%, and insulin from 0.06% to 3.8%. Sodium taurocholate, on the other hand, increased the permeability to 0.13%, 0.38%, 0.0011%, and 0.14%, respectively. Taurodeoxycholate was more effective than taurocholate in the nasal epithelium as well [202], This difference in activities can possibly be attributed to their micelle-forming capability, which is higher for taurodeoxycholate, a dihydroxy bile salt [190],... 

Conjunctival insulin absorption in rabbits estimated as plasma insulin levels after punctal occlusion was also shown to be increased by bile salts (sodium deoxycholate, glycocholate, and taurocholate) and a surfactant (polyoxyethylene-9-lauryl ether) [200], Their rank order of effectiveness at 1% was sodium deoxycholate > polyoxyethylene-9-lauryl ether > sodium glycocholate = sodium taurocholate. There was an 18-, 29-, 3-, and 3-fold increase, respectively, in conjunctival absorption. Sodium deoxycholate, a dihydroxy bile salt, was more effec-... 

T Murakami, Y Sasaki, R Yamajo, N Yata. (1984). Effect of bile salt on the rectal absorption of sodium ampicillin in rats. Chem Pharm Bull 32 1948-1955. 

BJ Aungst, NJ Rogers, E Shefter. (1988). Comparison of nasal, rectal, buccal, sublingual, and intramuscular insulin efficacy and the effects of a bile salt absorption promoter. J Pharmacol Exp Therap 244 23-27. 

RJ Leipold. Description and simulation of a tubular, plug-flow model to predict the effect of bile sequestrants on human bile salt excretion. J Pharm Sci 84 670-672, 1995. 

The return of the bile salts to the liver from the small intestine is the most potent stimulus of bile secretion. In fact, these bile salts may cycle two to five times during each meal. The intestinal hormone secretin, which is released in response to acid in the duodenum, enhances aqueous alkaline secretion by the liver. Secretin has no effect on the secretion of bile salts. During the cephalic phase of digestion, before food even reaches the stomach or intestine, parasympathetic stimulation, by way of the vagus nerve, promotes bile secretion from the liver. 

Bile acids and salts have been found to enhance the absorption of both calcium and vitamin D hence, to increase calcium absorption both directly and indirectly (3,37). However, the ability of some dietary fibers such as lignin and pectin to absorb conjugated and deconjugated bile salts onto their surfaces to be excreted in the feces (a mechanism credited to the hypocholesterolemic effect of some dietary fibers) may result in an overall decrease in calcium absorption from the gastrointestinal tract (7,33,38-40). 

Surfactants may increase the solubility of the drug via micelle formation, but the amounts of material required to increase solubility significantly are such that at least orally the laxative effects are likely to be unacceptable. The competition between the surfactant micelles and the absorption sites is also likely to reduce any useftd effect and make any prediction of net overall effect difficult. However, if a surfactant has any effect at all, it is likely to be in the realm of agents that help disperse suspensions of insoluble materials and make them available for solution. Natural surfactants, in particular bile salts, may enhance absorption of poorly soluble materials. 

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