Bile salts have deleterious effects on a variety of organs, cells, and subcellular organelles. Several bile salts, predominantly monohydroxy bile salts, have the capacity to produce cholestasis and changes in gross liver structure and hepatocytic ultrastructure in experimental animals and in vitro preparations. It is also apparent that liver disease results in profound changes in the pattern of bile acid metabolism, some of which theoretically could be harmful and some protective. It is not possible at present to give a clear answer to the question of whether bile salts participate in the initiation or perpetuation of human liver disease, although the evidence reviewed here suggests that in certain circumstances they may.
Palmer RH. Bile Acids, Liver Injury, and Liver Disease. Arch Intern Med. 1972;130(4):606–617. doi:10.1001/archinte.1972.03650040130012
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