Ursodeoxycholic Acid - A drug that protects the liver with the "power of bile"

1. Introduction: Liver function and the rise of diseases

The liver is known as the "silent organ" of our body.This is because even if the condition worsens slightly, you are less likely to feel pain and symptoms are less likely to appear.However, the liver performs many important tasks, such as breaking down food and converting it into energy, neutralizing alcohol, drugs, and waste products, and producing bile to help digest fat.

When the liver becomes fatigued or inflamed, blood tests show elevated levels of GPT, AST, and γ-GTP, which are signs of liver cell damage.In such cases, one of the medications often prescribed by doctors is ursodeoxycholic acid (UDCA), which is widely known in Japan under the names Urso® and Ursodes®.

2. What is Ursodeoxycholic Acid? - A Compound Found in Bears

The name "urso" of ursodeoxycholic acid comes from the Latin word "ursus," which means "bear."In fact, this medicine is a natural ingredient discovered in bear bile.

Bear bile, found in the gallbladder of bears, has long been prized as a valuable herbal medicine in East Asia. It was even mentioned in the Shennong Bencao Jing, a Chinese medical text dating back over 2,000 years, where it was described as "reducing fever, eliminating toxins, and treating liver diseases."In Japan, it was traded as a highly priced medicinal herb during the Edo period and was used to treat hepatitis, jaundice, and as an antipyretic.

The main component of this bear bile was later chemically identified.Ursodeoxycholic acid(Ursodeoxycholic acid).It is sometimes referred to as "UDCA," which is an acronym of the English name.

3. History of research and synthesis – from natural to artificial

In the mid-20th century, research began to scientifically elucidate the effects of bear bile.In the 1950s, Japanese researchers analyzed the components of bear bile and identified a new type of bile acid, ursodeoxycholic acid, as its main component.

Bile acids are substances made from cholesterol in the liver and secreted into the small intestine to digest fats.Although small amounts of UDCA are naturally present in the human body, bear bile contains significantly higher amounts.

Initially, it was extracted from bear bile, but from an animal conservation perspective, capturing bears posed ethical and sustainability challenges.Therefore, since the 1960s, Japanese pharmaceutical companies and research institutes have collaborated to chemically synthesize ursodeoxycholic acid.artificial synthesisWe have established the technology to do this.This allowed for stable production of the drug without sacrificing bears, and it began to be officially used as a medicine in the 1970s.

4. What are bile acids? They act like "detergents that dissolve oil"

Bile acids act as "detergents" in the body.The fats we consume through our diet are not easily soluble in water.However, bile acids emulsify (finely disperse) fat, making it easier for digestive enzymes to work.

Bile acids produced in the liver undergo the "enterohepatic circulation" in which some are reabsorbed in the intestine and returned to the liver.When this balance is disrupted, bile stagnates, damaging liver cells, and cholesterol solidifies in the gallbladder.gallstonesWe create things like this.

Ursodeoxycholic acid improves bile flow and protects the liver and gallbladder.

5. Mechanism of action

Ursodeoxycholic acid has multiple functions.The main effects can be explained simply as follows:

(1) Improves bile flow (choleretic effect)

It helps smooth the flow of bile produced in the liver and prevents it from stasis (cholestasis).This reduces harmful bile acids that have accumulated in liver cells, alleviating inflammation and damage to the cells.

(2) Protecting liver cells (cytoprotection)

Harmful bile acids (such as deoxycholic acid) have the ability to damage liver cells.Ursodeoxycholic acid replaces them, neutralizing the toxicity and stabilizing liver cell membranes.

(3) Dissolves cholesterol (gallstone dissolving effect)

Most gallstones are formed by hardened cholesterol.Urso works by lowering the cholesterol concentration in bile and gradually dissolving existing stones.

(4) Reduces immune response (immunomodulatory effect)

In conditions such as primary biliary cholangitis (PBC), the bile ducts become inflamed due to an autoimmune process.Urso suppresses the immune system's overreaction and slows the progression of inflammation.

(5) Reduces oxidative stress (antioxidant effect)

It suppresses "active oxygen" that damages cells and protects liver cells.

6. Main indications (what diseases is it used for)

Ursodeoxycholic acid is a drug that is very widely used in Japan.We will introduce some representative applications.

● Improvement of liver dysfunction

This medicine improves liver function when liver enzymes are elevated due to chronic hepatitis, fatty liver, drug-induced liver damage, etc.It does not cure hepatitis itself, but it reduces inflammation and helps the liver regenerate.

Cholestatic liver disease

It improves jaundice and itching caused by poor bile flow.

Primary biliary cholangitis (PBC)

It is an autoimmune disease that causes inflammation of the bile ducts.Urso is a treatment for PBCFirst-choice drugsand has been shown to slow the progression of the disease.

● Gallstones (cholesterol stones)

It is sometimes used as a treatment to dissolve stones without surgery (however, its effectiveness is limited depending on the type and size of the stone).

● Other

It may also be used to treat alcoholic liver disease, non-alcoholic steatohepatitis (NASH), and cholestasis of pregnancy.

7. Who uses it?

There are many different causes of liver disease.Causes include viruses (types B and C), fat accumulation, medications, alcohol, autoimmune diseases, and genetics.

Among these, Urso is effective in cases where there is a deterioration in bile flow or a decrease in liver function due to inflammation.It may also be prescribed to people with mild liver damage without symptoms or who have high liver levels in a health check.

8. Side Effects and Safety

Urso is considered a relatively safe drug even when taken over a long period of time.Side effects are few, and if they do occur, they are mainly mild gastrointestinal symptoms.

Common side effects:

• Diarrhea, abdominal pain, nausea

• Rash, itching (rare)

• Very rarely, elevated liver enzymes (or worsening of the condition)

It can be used safely as long as you have regular blood tests under the supervision of your doctor.It is also considered relatively safe for pregnant and nursing women and may be prescribed for cholestasis during pregnancy.

9. Global Recognition and Research Expansion

Ursodeoxycholic acid is a drug that was developed in Japan and has spread throughout the world.Since the 1980s, clinical research has progressed in Europe and the United States, and it has become internationally recognized as a standard treatment for liver disease.

In particular, its effectiveness against primary biliary cholangitis (PBC) is clearly stated in global guidelines.In recent years, research has also been conducted into its application to non-alcoholic steatohepatitis (NASH), liver damage associated with diabetes, and improving liver function after transplantation.

10. Differences from other drugs

There are many types of liver medications, including liver strengtheners, detoxifiers, and vitamin supplements.Among them, Urso is unique in that it "regulates the flow of bile."It is not just a liver function improver, but also supplements bile acids to restore the body's metabolic balance.Physiological drugsIt can be said that...

11. From Bear Gallbladder to the Future: The Fusion of Nature and Science

It has been more than half a century since bear bile was once highly valued.Ursodeoxycholic acid is a symbolic drug that represents humanity's scientific elucidation of the "wisdom of nature" and its application in an ethical and safe manner.Now, the same compound can be artificially produced while protecting bears, and patients around the world are benefiting from it.

12. Important points for taking the medicine

• It is usually taken in 2 to 3 divided doses a day.

• Taking it after a meal improves absorption and reduces stomach irritation.

• If you miss a dose, take only one dose when you remember (be careful not to take it twice).

• Long-term use is often necessary, so it is important to continue taking the medication even if you have no symptoms.

13. Future Outlook - From UDCA to New Drugs

In recent years, new drugs (e.g., obeticholic acid = OCA) have been developed that are based on the structure of ursodeoxycholic acid.These more potently stimulate bile acid receptors and are being applied to the treatment of fatty liver and metabolic diseases.In other words, UDCA marked the beginning of a new medical field known as "bile acid therapy."

14. Summary - The first step to taking care of your liver

Ursodeoxycholic acid originated from bear bile and is a "liver-protecting drug" that has been recognized worldwide after many years of research.Because the liver is an organ that continues to work silently, early care is important.When blood test results are high, when you have chronic hepatitis, or when your lifestyle tends to be irregular...Urso acts as a quiet "supporter" for your liver.

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