Differences in the metabolism and disposition of ursodeoxycholic acid and of its taurine-conjugated species in patients with primary biliary cirrhosis

Hepatology. 1999 Feb;29(2):320-7. doi: 10.1002/hep.510290220.


The clinical effectiveness of ursodeoxycholate in the treatment of liver disease may be limited by its poor absorption and extensive biotransformation. Because in vitro and in vivo studies suggest that the more hydrophilic bile acid tauroursodeoxycholate has greater beneficial effects than ursodeoxycholate, we have compared for the first time the absorption, metabolism, and clinical responses to these bile acids in patients with primary biliary cirrhosis (PBC). Twelve female patients with PBC were sequentially administered tauroursodeoxycholate and ursodeoxycholate (750 mg/d for 2 months) in a randomized, cross-over study. Bile acids were measured in serum, duodenal bile, urine, and feces by gas chromatography-mass spectrometry (GC-MS). Biliary ursodeoxycholate enrichment was higher during tauroursodeoxycholate administration (32.6% vs. 29.2% during ursodeoxycholate; P <.05). Lithocholic acid concentration was consistently higher in all biological fluids during ursodeoxycholate administration. Fecal bile acid excretion was the major route of elimination of both bile acids; ursodeoxycholate accounted for 8% and 23% of the total fecal bile acids during tauroursodeoxycholate and ursodeoxycholate administration, respectively (P <.05). Tauroursodeoxycholate was better absorbed than ursodeoxycholate, and, although it was partially deconjugated and reconjugated with glycine, it underwent reduced biotransformation to more hydrophobic metabolites. This comparative study suggests that tauroursodeoxycholate has significant advantages over ursodeoxycholate that may be of benefit for long-term therapy in PBC.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorption
  • Adult
  • Aged
  • Bile / chemistry
  • Bile Acids and Salts / analysis
  • Bile Acids and Salts / blood
  • Bile Acids and Salts / urine
  • Cross-Over Studies
  • Duodenum / metabolism
  • Feces / chemistry
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Lithocholic Acid / analysis
  • Lithocholic Acid / blood
  • Lithocholic Acid / urine
  • Liver Cirrhosis, Biliary / metabolism*
  • Middle Aged
  • Taurochenodeoxycholic Acid / analysis
  • Taurochenodeoxycholic Acid / pharmacokinetics*
  • Ursodeoxycholic Acid / analysis
  • Ursodeoxycholic Acid / pharmacokinetics*


  • Bile Acids and Salts
  • Taurochenodeoxycholic Acid
  • Lithocholic Acid
  • ursodoxicoltaurine
  • Ursodeoxycholic Acid