Cholesterol cholelithiasis: part of a systemic metabolic disease, prone to primary prevention

Expert Review of Gastroenterology & Hepatology
Agostino Di CiaulaPiero Portincasa

Abstract

Cholesterol gallstone disease have relationships with various conditions linked with insulin resistance, but also with heart disease, atherosclerosis, and cancer. These associations derive from mechanisms active at a local (i.e. gallbladder, bile) and a systemic level and are involved in inflammation, hormones, nuclear receptors, signaling molecules, epigenetic modulation of gene expression, and gut microbiota. Despite advanced knowledge of these pathways, the available therapeutic options for symptomatic gallstone patients remain limited. Therapy includes oral litholysis by the bile acid ursodeoxycholic acid (UDCA) in a small subgroup of patients at high risk of postdissolution recurrence, or laparoscopic cholecystectomy, which is the therapeutic radical gold standard treatment. Cholecystectomy, however, may not be a neutral event, and potentially generates health problems, including the metabolic syndrome. Areas covered: Several studies on risk factors and pathogenesis of cholesterol gallstone disease, acting at a systemic level have been reviewed through a PubMed search. Authors have focused on primary prevention and novel potential therapeutic strategies. Expert commentary: The ultimate goal appears to target the manageable...Continue Reading

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Citations

Dec 7, 2019·Journal of Cellular and Molecular Medicine·Qi SunYouxin Wang
May 1, 2021·Journal of Personalized Medicine·Irina Grigor'evaMarsel Kabilov
May 5, 2021·Genes and Environment : the Official Journal of the Japanese Environmental Mutagen Society·Haifeng ZhuLinsong Feng
Jul 3, 2021·Medical Sciences : Open Access Journal·Sanjay KalraPawan Rawal
Oct 9, 2021·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Lanlan ChenGuoyue Lv

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