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The ursodeoxycholic acid story in primary biliary cirrhosis.

The name ursodeoxycholic acid (UDCA) is derived from 'ursocholeinische saure' used by Hammarsten in 1902 to describe a bile acid discovered in polar bears. The bile acid he identified was actually chenodeoxycholic acid.1 UDCA is the 7P epimer of chenodeoxycholic acid and has the chemical structure 3a 7,B-dihydroxy-5p-cholan-24-oic acid.2 Ten years ago, Leuschner et al3 made the serendipitous observation that UDCA given for gall stone dissolution noticeably improved routine liver function tests in patients who also had chronic liver disease. Since then, there have been reports of potential benefits in a wide range of cholestatic and chronic inflammatory liver conditions,4 but most is known about the use of UDCA in primary biliary cirrhosis (PBC). In this article, we first discuss the pathogenesis ofPBC and possible mechanisms of action of UDCA, and then review its clinical efficacy.