A. Stiehl – författare

Since the last International Bile Acid Meeting in San Diego in 1994, new advances have been made in the understanding of bile acid metabolism and transport. The cytotoxic as well as the therapeutic effects of specific bile acids have been further explored and the beneficial effects of ursodeoxycholic acid in various chronic cholestatic conditions have been substantiated. Much basic and clinical research has been conducted to unravel the underlying mechanisms of action. This volume, the proceedings of Falk Symposium No. 93 (XIV International Bile Acid Meeting), held in Freiburg-im-Breisgau, Germany, October 22-24, 1996, is dedicated to both basic and clinical aspects of bile acid research related to the role of bile acids in hepatobiliary diseases.

Primary sclerosing cholangitis is a chronic disease of the intra and extrahepatic bile ducts leading to obstructions and dilatations followed by liver cirrhosis and in some cases cholangiocarcinoma. In 50% of cases primary sclerosing cholangitis is associated with inflammatory bowel disease. The cause of the disease is unknown and many questions concerning the pathogenesis still remain open. In recent years our knowledge of the natural course, the risk of cholangiocarcinoma and the possibility of medical, endoscopic and surgical treatment has increased. Ursodeoxycholic acid, endoscopic treatment and liver transplantation have become standard therapeutic procedures. This book is the proceedings of the Falk Workshop held on October 3, 1997, in Freiburg, Germany (Part II of the Liver Week Freiburg 1997), and covers the most important aspects of this disease.

Beginning in 1970, the International Bile Acid Meeting has taken place every two years and each time new progress in our understanding of the complex role of bile acids in many metabolic processes of the liver and the intestine has been revealed by a selected group of leading scientists from all over the world. Although originally mainly physiological data on bile acid synthesis and transport were emphasized, and later on also the therapeutic benefit of bile acids in gallstone disease and cholestasis was discovered, we have come now to the molecular biology and genetic era with major discoveries in transport defects and related diseases. This book is the proceedings of Falk Symposium No. 120, held in The Hague, The Netherlands, on October 12-13, 2000 - the 16th International Bile Acid Meeting. One of the main discoveries recently has been the identification of nuclear receptors for bile acids, which gives them a much broader perspective than previously anticipated. It even suggests that bile acids can regulate their biosynthesis and enterohepatic circulation transcriptionally. It will therefore not be surprising that this topic, together with the molecular regulation of cholesterol 7alpha-hydroxylase and cholesterol homeostasis, has a dominant place in these proceedings. Another important topic is the progress in our molecular understanding of hepatic (both at the basolateral and canalicular sites), cholangiocytic and intestinal bile acid transport processes. Further insights into genetic defects causing cholestasis or intestinal malabsorption in animal models and in human diseases are also discussed by a number of well-known authors. Finally the last section deals with new findings on the role of bile acid therapy in cholestatic syndromes or chemoprevention and with the potential benefit of bile acid inhibitors. All contributors provide an update on the most recent developments in their field.

Since the International Bile Acid Meeting in The Hague in 2000, bile acid research has continued to flourish and therapeutic use of bile acids has attained a broader role. Bile acid research has been stimulated by the discovery that bile acids specifically bind to receptors of the cell nucleus. Thereby, they regulate the transcription of transport proteins and enzymes involved in synthesis, transport and metabolism of bile acids and maintain cholesterol homeostasis. Knowledge about genetic defects of bile acid transport which may cause cholestasis or intestinal malabsorption has also increased impressively. Therapy of chronic cholestatic liver diseases, especially of primary biliary cirrhosis, with ursodeoxycholic acid represents an important advance in modern hepatology and has stimulated basic and clinical research to unravel the underlying mechanisms of action and to optimize treatment schedules.This book is the proceedings of Falk Symposium 129, the XVII International Bile Acid Meeting held in Freiburg, Germany, May 30-June 1, 2002, which was again dedicated to both basic and clinical aspects of bile acid research, with a focus on the role of bile acids in hepatobiliary and intestinal diseases. The most up-to-date findings are presented by leading scientists and clinicians in the field.

During the last decade, knowledge about cholestatic liver disease and concomitant diseases, such as ulcerative colitis, cholangio- and hepatocellular carcinoma, pancreas and colon cancer, has increased considerably. Studies on ursodeoxycholic acid treatment alone or in combination with immunosuppressive compounds and their positive effects on biliary liver disease as well as on so-called overlap syndromes or intestinal tumors are published in increasing numbers, and stimulate discussion on whether or not ursodeoxycholic acid is able to improve the general condition and/or life expectancy of patients. On the other hand, genetics, aetiological and pathogenetic aspects are still difficult to comprehend, but are the absolute prerequisite for the development of better treatment options. This book is the proceedings of Falk Symposium No. 136 (Part I of the XII Falk Liver Week, held in Freiburg, Germany, on October 15-16, 2003), and contains stimulating, exciting and controversial papers on clinical and also basic research at the highest scientific level.

This book contains the proceedings of the XIIIth International Bile Acid Meeting (Falk Symposium 80), an official satellite meeting of the World Congress of Gastroenterology, held in San Diego, California, U.S.A., September 30--October 2, 1994. It begins with presentations of major advances in bile acid chemistry, biology and pharmacology. The new structure proposed for the mixed micelles present in bile is reviewed, as are the properties of new synthetic analogues of bile acids. The mechanisms by which bile acids interact with cell membranes are discussed in order to provide insight into the hepatotoxic effects of bile acids in cholestatic liver disease. The book further shows the exciting progress in the molecular biology of bile acid transport by the hepatocyte and enterocyte, and concludes with a consensus on the use of ursodeoxycholic acid in cholestatic liver disease and as an adjunct to immunosuppressive therapy after liver transplantation, and to interferon therapy in chronic viral hepatitis.