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@article{Ovadia:2020:10.1038/s41598-020-60821-w,
author = {Ovadia, C and Perdones-Montero, A and Fan, HM and Mullish, BH and McDonald, JAK and Papacleovoulou, G and Wahlström, A and Ståhlman, M and Tsakmaki, A and Clarke, LCD and Sklavounos, A and Dixon, PH and Bewick, GA and Walters, JRF and Marschall, H-U and Marchesi, JR and Williamson, C},
doi = {10.1038/s41598-020-60821-w},
journal = {Scientific Reports},
title = {Ursodeoxycholic acid enriches intestinal bile salt hydrolase-expressing Bacteroidetes in cholestatic pregnancy},
url = {http://dx.doi.org/10.1038/s41598-020-60821-w},
volume = {10},
year = {2020}
}

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TY  - JOUR
AB  - <jats:title>Abstract</jats:title><jats:p>Ursodeoxycholic acid (UDCA) treatment can reduce itch and lower endogenous serum bile acids in intrahepatic cholestasis of pregnancy (ICP). We sought to determine how it could influence the gut environment in ICP to alter enterohepatic signalling. The gut microbiota and bile acid content were determined in faeces from 35 pregnant women (14 with uncomplicated pregnancies and 21 with ICP, 17 receiving UDCA). Faecal bile salt hydrolase activity was measured using a precipitation assay. Serum fibroblast growth factor 19 (FGF19) and 7α-hydroxy-4-cholesten-3-one (C4) concentrations were measured following a standardised diet for 21 hours. Women with a high ratio of<jats:italic>Bacteroidetes</jats:italic>to<jats:italic>Firmicutes</jats:italic>were more likely to be treated with UDCA (Fisher’s exact test p = 0.0178) than those with a lower ratio. Bile salt hydrolase activity was reduced in women with low<jats:italic>Bacteroidetes</jats:italic>:<jats:italic>Firmicutes</jats:italic>. Women taking UDCA had higher faecal lithocholic acid (p < 0.0001), with more unconjugated bile acids than women with untreated ICP or uncomplicated pregnancy. UDCA-treatment increased serum FGF19, and reduced C4 (reflecting lower bile acid synthesis). During ICP, UDCA treatment can be associated with enrichment of the gut microbiota with<jats:italic>Bacteroidetes</jats:italic>. These demonstrate high bile salt hydrolase activity, which deconjugates bile acids enabling secondary modification to FXR agonists, enhancing enterohepatic feedback via FGF19.</jats:p>
AU  - Ovadia,C
AU  - Perdones-Montero,A
AU  - Fan,HM
AU  - Mullish,BH
AU  - McDonald,JAK
AU  - Papacleovoulou,G
AU  - Wahlström,A
AU  - Ståhlman,M
AU  - Tsakmaki,A
AU  - Clarke,LCD
AU  - Sklavounos,A
AU  - Dixon,PH
AU  - Bewick,GA
AU  - Walters,JRF
AU  - Marschall,H-U
AU  - Marchesi,JR
AU  - Williamson,C
DO  - 10.1038/s41598-020-60821-w
PY  - 2020///
TI  - Ursodeoxycholic acid enriches intestinal bile salt hydrolase-expressing Bacteroidetes in cholestatic pregnancy
T2  - Scientific Reports
UR  - http://dx.doi.org/10.1038/s41598-020-60821-w
UR  - http://hdl.handle.net/10044/1/76888
VL  - 10
ER  -

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