Bile exerts multiple functions in the liver and gut playing a crucial role for triglyceride-, sterol- and carbohydrate-metabolism. Moreover, bile acids have been evidenced to be potent modulators of the intestinal flora, intestinal integrity and inflammation. The latter being also relevant for epithelial/cellular regeneration / healing and carcinogenesis. Therefore, bile is a key player in disease processes including liver regeneration, hepatic and colonic cancer, inflammatory bowel disease and metabolic syndrome (with all associated features such as fatty liver disease, diabetes, hypertension). Finally, composition of bile within the gallbladder contributes largely to the pathogenesis of gallstones. In fact, therapeutic supplementation of specific bile acids, such as obeticholic acid has been shown to counteract obesity, improve insulin sensitivity, ameliorate diet-induced liver injury, stabilize the intestinal barrier/integrity and exert anti-inflammatory actions at the intestinal mucosa level. We focus our research on the role of bile/acids on i) mucus secretion and intestinal barrier function ii) impact of intestinal microbial diversity on metabolism and bile composition as well as iii) effects achieved by bariatric surgery mediated by changes in bile composition and intestinal actions; iv) liver regeneration after major liver surgery and course of the patient after liver transplantation and v) on the impact of farnesoid X receptor (FXR) activation in different diseases. The clear patho- and physiological relevance of bile/acids evidenced experimentally by multiple and independent high-quality publications for clinical entities such as obesity, chronic liver disease, inflammatory bowel disease and intrahepatic malignancies contrasts with the shear lack of diagnostic tools in humans.
The bile in the gallbladder closely reflects the bile acid pool available and being secreted into the gut. Therefore, in oder to translate the stated experimental knowledge into human health care our aim is to: i) establish a diagnostic method utilizing 1H-NMR-spectroscopy in determining bile composition of the gallbladder non-invasively in humans and ii) using this method for work-up of patients with obesity (before and after bariatric surgery), inflammatory bowel disease, liver surgery, -cirrhosis, -transplantation and/ or biliary cancer.
- Prof. Guido Beldi
- Prof. Andrea De Gottardi
- Prof. Peter Vermathen
- Dr. Dino Kröll
- Dr. Philipp Nett
- Dr. Guido Stirnimann
- Bile effects on intestinal barrier (including mucus, mucosa-associated lymphatic tissue, microbiome), metabolism and liver (injury, regeneration, fibrosis, fat storage)
- Clinical Research on alterations in and effects of microbiome in various disease states (obesity, inflammatory bowel disease, liver disease)
|Prof. Dr. med. Reiner Wiest|