第8章-肝胆疾病的生物化学诊断-.ppt

Bile Acid Bile acids are steroid acids类烷胆酸 found predominantly in the bile of mammals.Bile salts are bile acids compounded with a cation阳离子, usually sodium钠. In humans, the salts of taurocholic acid牛磺胆酸 and glycocholic acid (甘氨胆酸，derivatives of cholic acid胆酸衍生物) represent approximately eighty percent of all bile salts. Bile acids, glycine 甘氨酸 and taurine conjugates牛磺酸缀合物, and 7-alpha-dehydroxylated derivatives脱羟基衍生物 (deoxycholic acid 脱氧胆酸and lithocholic acid石胆酸) are all found in human intestinal bile. An increase in bile flow is exhibited表现、展现 with an increased secretion of bile acids. The main function of bile acid is to facilitate促进 the formation of micelles微粒, which promotes processing of dietary fat. Production and distribution In humans, bile acid synthesis begins when liver cells synthesize the two primary bile acids, cholic acid 胆酸 and chenodeoxycholic acid鹅脱氧胆酸 via the cytochrome细胞色素 P450-mediated oxidation of cholesterol胆固醇. Approximately 600 mg of bile salts are synthesized daily to replace bile acids lost in the feces粪.In humans, the rate-limiting step is the addition of a hydroxyl group羟基 on position 7 of the steroid nucleus甾核 by the enzyme cholesterol 7 alpha-hydroxylase胆固醇7α-羟化酶. This enzyme is down-regulated by cholic acid and up-regulated by cholesterol. When these two bile acids are secreted into the lumen腔 of the intestine, intestinal bacteria dehydroxylate羟化 a portion of each of them to form the secondary bile acids, deoxycholic acid脱氧胆酸 and lithocholic acid石胆酸.(Cholic acid becomes deoxycholic acid. Chenodeoxycholic acid becomes lithocholic acid.) All four of these bile acids can be taken back up into the blood stream, return to the liver, and be resecreted in a process known as enterohepatic circulation肠肝循环. Prior to secreting any of the four bile acids, the liver cells may also conjugate them with one of two amino acids, glycine or taurine甘氨酸或牛磺酸, to form a total of 8 possible conjugated bile acids. Conjugating bile acids are almost always in t