Ursodeoxycholic Acid in Liver Cirrhosis: A Chinese Perspective

Bile acids (BAs) not only play critical roles in liver-gut immune homeostasis but also participate in regulating lipid, glucose, and energy metabolism. BAs transporter defect or signaling pathways abnormal activation are linked to cholestasis, inflammation, fibrosis, carcinogenesis, and metabolic disorders. BAs and related signaling pathways have become attractive therapeutic targets for inflammation, fibrosis, and metabolic diseases, including type 2 diabetes mellitus and non-alcoholic fatty liver disease (NAFLD). Hydrophilic BAs, including ursodeoxycholic acid (UDCA), tauroursodeoxycholic (TUDCA), and 24-norursodeoxycholic (nor-UDCA), have hepatoprotective properties and are widely used in cholestatic liver diseases. Here, we provide an overview of the mechanism and recent clinical application of UDCA in hepatobiliary diseases, as well as BAs cross-talk with the gut microbiota in health and diseases. Targeting bile-acid signaling for liver cirrhosis is a promising and effective strategy. Evidences from clinical trials suggest that UDCA treatment has beneficial effects on cirrhosis.