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The Pathological Effects of Circulating Hydrophobic Bile Acids in Alzheimer's Disease.

Ehtezazi, T, Rahman, K, Davies, R and Leach, AG (2023) The Pathological Effects of Circulating Hydrophobic Bile Acids in Alzheimer's Disease. Journal of Alzheimer's disease reports, 7 (1). pp. 173-211. ISSN 2542-4823

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Open Access URL: https://doi.org/10.3233/adr-220071 (Published version)


Recent clinical studies have revealed that the serum levels of toxic hydrophobic bile acids (deoxy cholic acid, lithocholic acid [LCA], and glycoursodeoxycholic acid) are significantly higher in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) when compared to control subjects. The elevated serum bile acids may be the result of hepatic peroxisomal dysfunction. Circulating hydrophobic bile acids are able to disrupt the blood-brain barrier and promote the formation of amyloid-β plaques through enhancing the oxidation of docosahexaenoic acid. Hydrophobic bile acid may find their ways into the neurons via the apical sodium-dependent bile acid transporter. It has been shown that hydrophobic bile acids impose their pathological effects by activating farnesoid X receptor and suppressing bile acid synthesis in the brain, blocking NMDA receptors, lowering brain oxysterol levels, and interfering with 17β-estradiol actions such as LCA by binding to E2 receptors (molecular modelling data exclusive to this paper). Hydrophobic bile acids may interfere with the sonic hedgehog signaling through alteration of cell membrane rafts and reducing brain 24(S)-hydroxycholesterol. This article will 1) analyze the pathological roles of circulating hydrophobic bile acids in the brain, 2) propose therapeutic approaches, and 3) conclude that consideration be given to reducing/monitoring toxic bile acid levels in patients with AD or aMCI, prior/in combination with other treatments.

Item Type: Article
Uncontrolled Keywords: Alzheimer’s disease; blocking NMDA receptors; blood-brain barrier; declining cognitive function; liver dysfunction; serum bile acids
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RM Therapeutics. Pharmacology
Divisions: Pharmacy & Biomolecular Sciences
Publisher: IOS Press
SWORD Depositor: A Symplectic
Date Deposited: 05 Apr 2023 10:23
Last Modified: 05 Apr 2023 10:23
DOI or ID number: 10.3233/adr-220071
URI: https://researchonline.ljmu.ac.uk/id/eprint/19224
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