Ursodiol

Ursodiol is a naturally occurring, hydrophilic bile acid used primarily as an adjunctive treatment for hepatobiliary disease in dogs and cats. **Clinical Highlights:** * **Hepatoprotective:** It is highly beneficial in chronic liver diseases, particularly where cholestasis (bile toxicity) plays a role, such as cholangitis, cholangiohepatitis, and copper-associated hepatopathy. * **Gallstone Dissolution:** It can be used for the medical management of cholesterol-containing gallstones (radiolucent stones). * **Immunomodulatory:** It may help slow the progression of inflammatory hepatic disorders, including autoimmune hepatitis. > **Clinical Pearl:** Unlike hydrophobic bile acids which are toxic to cell membranes, ursodiol is a cytoprotective hydrophilic bile acid. It shifts the bile acid pool to a less toxic profile, reducing hepatocyte apoptosis and oxidative stress.

กลไกการออกฤทธิ์: Ursodiol exerts its effects through multiple hepatoprotective and choleretic pathways: * **Cholesterol Reduction:** Suppresses hepatic synthesis and secretion of cholesterol and decreases intestinal absorption of cholesterol. * **Gallstone Solubilization:** By reducing cholesterol saturation in the bile, it allows the solubilization of cholesterol-containing gallstones. * **Choleretic Effect:** Increases bile flow, which helps flush toxic bile acids from the liver. * **Cytoprotection:** Reduces the hepatocyte toxic effects of endogenous hydrophobic bile salts (e.g., lithocholate, deoxycholate) by decreasing their detergent action on cell membranes, thereby protecting hepatic cells from apoptosis and necrosis.

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