SEARCH · PubMed Health

Results for “CHOLESTYRAMINE”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,495 records · Page 83Linked to original sources

PubMed1981

Gallstone formation in guinea pigs under different dietary conditions. Effect of vitamin C on bile acid pattern.

Guinea pigs formed gallstones when fed chow supplemented with cholesterol and cholic acid. Although the stones contained little or no cholesterol the changes in biliary bile acid and lipid composition were similar to those observed in other rodents under conditions of cholesterol gallstone formation. Addition of cholestyramine to chow had a midly lithogenic effect. Hypovitaminosis C in animals given cholesterol and cholic acid resulted in an increase of the cholesterol content of the gallstones. The composition of biliary bile acids was markedly changed. Reductive formation of deoxycholic acid decreased and oxidative formation of ketonic bile acid increased. The results show that vitamin C may influence the redox state of the intestinal microorganisms microorganisms responsible for these conversions.

Animals↗

PubMed1981

The influence of bile acids on biliary excretion of indocyanine green in rats of different ages.

In rats of different ages bile flow and biliary excretion of indocyanine green (ICG) were estimated in dependence on bile acid excretion. In 20, 30, 60 and 180 day old rats bile acid excretion was diminished to a quarter of the control by pretreatment with cholestyramine (1.5 g/kg b.wt.). To enhance bile acid excretion, taurocholate sodium (TC, 50 mg/kg b.wt.) was given together with the dye. Bile acid depletion diminished the bile flow to a greater extent in young rats, which were found to have a higher bile acid dependent fraction of canalicular bile flow (60%) compared to 60 (35%) and 180 day old rats (20%). After bile acid depletion the decrease in ICG excretion was more pronounced in 30 and 60 day old rats which exhibit highest dye excretion rates. TC was able to enhance the bile flow in all age groups investigated, however, the ICG excretion was enhanced only in adult animals. Our results indicate that the bile acid dependence of the hepatobiliary transport of ICG is influenced by age.

Age Factors↗

PubMed1980

Successful management of persistent diarrhoea in infants.

Ten infants with persistent, dehydrating diarrhoea were given a combination of gentamicin, metronidazole and cholestyramine by mouth. Daily stool weights were recorded before and during treatment, and in all cases there was a marked decrease in the severity of the diarrhoea. The combination of medications is a safe and effective form of treatment for persistent infantile diarrhoea.

Cholestyramine Resin↗

PubMed1980

Regulation of hepatic dolichol synthesis by beta-hydroxy-beta-methylglutaryl coenzyme A reductase.

Dolichol is an isoprenoid lipid involved in the assembly of many membrane-bound and secreted glycoproteins. Dolichol biosynthesis can be considered as a branch of the cholesterol biosynthetic pathway subsequent to the reaction catalyzed by beta-hydroxy-beta-methylglutaryl coenzyme A reductase (hydroxymethylglutaryl-CoA reductase, EC 1.1.1.34), the major regulatory enzyme of cholesterol biosynthesis. Changes in reductase activity can also affect the rate of dolichol synthesis. Since the majority of plasma glycoproteins are synthesized by the liver, we have measured the rate of dolichol synthesis in mouse-liver slices after various treatments which alter hepatic beta-hydroxy-beta-methyl-glutaryl-CoA reductase activity in vivo. The rate of hepatic dolichol synthesis was decreased by dietary cholesterol and fasting, and increased by feeding cholestyramine. There is also a diurnal variation in the rate of dolichol synthesis. A plot of the rate of dolichol synthesis versus the rate of cholesterol synthesis suggests that, after the formation of isoprene units, the branch of dolichol biosynthesis is saturated at a lower concentration of isoprene intermediates than is required to saturate the branch of cholesterol biosynthesis. After 2 weeks of cholesterol feeding and the consequent depression of hepatic dolichol synthesis, the rate of [3H]mannose incorporation into liver and plasma glycoproteins was unchanged, indicating that the rate of dolichol biosynthesis was not rate-limiting for total glycoprotein synthesis under these conditions.

Animals↗

PubMed1980

Rat liver acyl-coenzyme A:cholesterol acyltransferase: its regulation in vivo and some of its properties in vitro.

To gain insight into the role of the enzyme acyl-coenzyme A:cholesterol acyltransferase (ACAT) in cellular cholesterol homeostasis, its regulation in rat liver was investigated both in vivo and in vitro. In vitro assay conditions were optimized and some properties of the microsomal enzyme in vitro was also studied. Arrhenius plots of microsomal ACAT activity showed discontinuities at about 28-29 degrees C and 16-17 degrees C. Detergents above their critical micelle concentrations and organic solvents both inhibited the enzyme. Addition of progesterone or SC 31769, a 7-keto-cholesterol analogue, to microsomes inhibited activity while addition of 25-hydroxycholesterol increased the rate of cholesterol esterification, suggesting that the enzyme is susceptible to both negative and positive modulation by steroids, steroid analogues, or their metabolic products. Increasing the rate of cholesterol biosynthesis had a variable effect on ACAT activity. It was higher at the circadian peak of sterol biosynthesis than at the nadir. Increasing sterol biosynthesis by intragastric administration of mevalonolactone resulted in increased activity. In contrast, increasing the rate of sterol biosynthesis by feeding cholestyramine or administration of Triton WR 1339 had little effect on ACAT. Increasing hepatic cholesterol content by feeding cholesterol, cholate, or an atherogenic diet, fasting or intragastric administration of mevalonolactone all resulted in increased ACAT activity. ACAT activity showed a positive correlation with changes in microsomal free and esterified cholesterol contents. The response of ACAT to changes in hepatic cholesterol concentration in vivo and its response to changes in the rate of cholesterol synthesis support the hypothesis that this enzyme plays an important role in maintenance of hepatic cholesterol homeostasis.

Acyl Coenzyme A↗

PubMed1980

Antibiotic-associated pseudomembranous colitis in siblings.

Pseudomembranous colitis induced by antibiotics is not commonly diagnosed in children. Recent developments have clarified the pathogenesis and suggested that agents such as cholestyramine are therapeutically useful. Two siblings with pseudomembranous colitis were carefully studied and may serve to alert pediatricians to an approach to this entity.

Anti-Bacterial Agents↗

PubMed1995

The effect of acyl CoA: cholesterol acyltransferase inhibition on the uptake, esterification and secretion of cholesterol by the hamster small intestine.

Acyl CoA: cholesterol acyltransferase (ACAT) inhibitors are known to inhibit cholesterol absorption and are under investigation to reduce hypercholesterolemia. These studies examine the effect of an ACAT inhibitor 2,2-dimethyl-N-(2,4,6-trimethoxyphenyl)-dodecanamide (PD128042) on the uptake, metabolism and secretion of cholesterol by the hamster intestinal wall in a short-term model. Preliminary studies in this model indicated that the uptake of 14C-cholesterol and its subsequent esterification 2 hr postoral dosing occurs primarily in the duodenal and jejunal segments of the small intestine and most of the radiolabeled cholesterol and cholesteryl ester in the plasma was associated with chylomicrons. In both single- and multiple-dose studies, PD128042 (50 mg kg-1 day-1) did not inhibit intestinal uptake of [14C]-cholesterol but [14C]-cholesteryl ester formation was inhibited. The free [14C]-cholesterol appearing in plasma was not affected despite a large reduction in [14C]-cholesteryl ester. In contrast, cholestyramine (1 g kg-1 day-1) inhibited the uptake of the radiolabeled free cholesterol and the appearance of cholesteryl ester in the intestine and plasma. The effects of PD128042 on cholesterol and cholesteryl ester mass associated with scraped intestinal mucosa were consistent with the effects observed with the use of the radiolabeled cholesterol. In addition, PD128042 did not affect the uptake of appearance of radiolabeled triglyceride in the intestinal wall after oral gavage of 3H-trioleoylglycerol. Taken together, the data suggest that ACAT inhibition reduces cholesterol absorption by limiting cholesteryl ester incorporation into chylomicrons and has no effect on the intestinal processing of free cholesterol to be secreted into plasma.

Anilides↗

PubMed1993

Improvement in arterial stiffness during hypolipidaemic therapy is offset by weight gain.

Fourteen patients with familial hypercholesterolaemia were managed with dietary advice and simvastatin for 12 months. Either nicotinic acid or cholestyramine resin was added to the regimen if serum cholesterol was not less than 5.5 mmol/l within 18 weeks. After dietary advice but before commencing pharmacotherapy for hyperlipidaemia, arterial stiffness was measured in the common carotid and common femoral arteries. These studies were repeated after 12 months on pharmacotherapy. The primary objective of this study was to determine whether arterial stiffness could be altered with total cholesterol and low density lipoprotein (LDL) cholesterol lowering. Over the 12 month interval, serum total cholesterol, LDL cholesterol and triglycerides fell significantly, whereas high density lipoprotein (HDL) cholesterol and body mass index (BMI) rose significantly. Mean supine blood pressure did not change significantly. Arterial stiffness in the common carotid artery decreased from 1.04 +/- 0.21 x 10(5) N/m2 to 0.63 +/- 0.06 x 10(5) N/m2 (T = -2.67, P < 0.01) over the interval. Stiffness of the common femoral artery decreased from 2.10 +/- 0.57 x 10(5) N/m2 to 0.83 +/- 0.15 x 10(5) N/m2 (T = -2.73, P < 0.01). The change in arterial stiffness was not directly related to changes in circulating lipids or supine blood pressure. Increase in BMI, however, correlated with change in arterial stiffness in the common femoral artery (Rs = 0.53, P < 0.05) but not in the common carotid artery. An increase in BMI was associated with a smaller decrease in common femoral arterial stiffness. Aggressive hypolipidaemic therapy was therefore associated with a favourable effect on arterial wall stiffness.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1977

[The postvagotomy syndrome (author's transl)].

The postvagotomy syndrome following the operative section of the vagus nerves is characterized by diarrhoea. The incidence of diarrhoea after truneal vagotomy is about 25%, after selective vagotomy 15% and after proximal selective vagotomy only 2%. The possible pathogenetic factors are accelerated passage through the gut, disturbed bile acid metabolism, the bacterical inflammation of the small intestine, and enterohormonal dysregulation. A cholongenetic diarrhoea is probable because after vagotomy the excretion of bile acids is increased and the diarrhoea is interrupted after administring cholestyramin, which absorbs the bile salts in the intestine. In addition the pathogenetic role of an impaired function of the ileocecal valve should be discussed.

Bile Acids and Salts↗

PubMed1995

Serum concentration of 7 alpha-hydroxycholesterol as an indicator of bile acid synthesis in humans.

The serum concentration of 7 alpha-hydroxycholesterol as an indicator of total bile acid synthesis was investigated under different experimental conditions in humans. 7 alpha-Hydroxycholesterol was measured by gas-liquid chromatography-mass spectrometry, using [2H7]7 alpha-hydroxycholesterol and/or 5 alpha-cholestane-3 beta, 6 beta-diol as internal standards, and bile acid synthesis was estimated by the fecal balance method. Intraindividual variation was small when the concentration of 7 alpha-hydroxycholesterol was determined twice in the same subject 2 days to 11 months apart (7.3 +/- 6.5%, n = 52). In patients with advanced cirrhosis of the liver (n = 22) 7 alpha-hydroxycholesterol was 3.4-fold lower (22 ng/ml +/- 8) compared to matched controls (75 ng/ml +/- 19). Administration of cholestyramine (4 g b.i.d.) for 14 days increased 7 alpha-hydroxycholesterol concentration in five healthy volunteers from 40 +/- 11 ng/ml to 181 +/- 95 ng/ml (P = 0.02) and fecal excretion of acidic sterols from 254 +/- 60 mg/d to 1336 +/- 344 mg/d (P < 0.01). Although a significant correlation was found between 7 alpha-hydroxycholesterol in serum and bile acid synthesis in patients with hypercholesterolemia (r = 0.847, P < 0.001, n = 17), it was impossible to accurately determine bile acid synthesis from the serum levels of 7 alpha-hydroxycholesterol. Thus, determination of 7 alpha-hydroxycholesterol concentrations in serum can be used to assess changes in bile acid synthesis rates over short and long term periods under various experimental conditions, but not to calculate bile acid synthesis correctly.

Bile Acids and Salts↗

PubMed1996

Urinary excretion of mevalonic acid as an indicator of cholesterol synthesis.

Urinary excretion of mevalonic acid was investigated as an indicator of cholesterol synthesis. In normolipemic volunteers, excretion of mevalonic acid averaged 3.51 +/- 0.59 (SD) micrograms/kg x day1; (n = 24) and was not different from patients with hypercholesterolemia (3.30 +/- 0.92 micrograms/kg x day1; n = 24). In patients with cerebrotendineous xanthomatosis, the excretion was significantly higher (8.55 +/- 1.92 micrograms/kg x day1; n = 6, P < 0.001) but comparable to volunteers treated with cholestyramine (6.69 +/- 2.6 micrograms/kg x day1; n = 5). A significant correlation was found between 24-h excretion of mevalonic acid and cholesterol synthesis (r = 0.835; n = 35; P < 0.001). The coefficient of variation of excretion of mevalonic acid during 3 consecutive days was small (9.8%; n = 7). However, urinary output of mevalonic acid was significantly higher during the night (164 +/- 14 micrograms/12-h) than during the day (129 +/- 9 micrograms/12-h; n = 11; P < 0.05). In patients treated with simvastatin (40 mg/day) for 6 weeks, the ratio of mevalonic acid to creatinine in a morning urine sample decreased significantly compared to pretreatment values (110 +/- 25 micrograms/g vs. 66 +/- 25 micrograms/g; P < 0.001). Furthermore, the ratio of mevalonic acid to creatinine in a morning urine sample correlated with the ratio from the 24-h collection period (r = 0.714; n = 34; P < 0.001). The results indicate that the analysis of urinary mevalonic acid, either in 24-h collection or in a single morning sample, is an attractive method for evaluation of long and very short term changes of the rates of cholesterol synthesis.

Adult↗

PubMed1977

Biliary excretion studies with digoxin in man.

In 4 patients with a T-tube the biliary excretion of digoxin was measured for 48 hours. One patient a single intravenous bolus of 0.6 mg digoxin, while the other 3 patients were on maintenance therapy with 0.4 mg digoxin/day. From the single dose a total of 8.8% and 9.2% were excreted with the bile within 24 and 36 hours respectively. During steady-state the daily excreted amount varied between 2 and 10% of the dose in the 3 patients tested. In 2 normal volunteers the effect of the intraluminal binding agent cholestyramine on the pharmacokinetics of digoxin was investigated. The cross-over experiment did not exhibit any differences in the plasma level time profiles. These results indicate that minor amounts of digoxin are excreted with the bile which could contribute only to an insignificant enterohepatic cycling.

Adult↗

PubMed1976

Syndrome of intrahepatic biliary dysgenesis and cardiovascular malformations.

Peripheral pulmonary stenosis with or without intracardiac disease is described in 14 patients with intrahepatic biliary dysgenesis. Cardiovascular malformations were not present among a large group of patients with extrahepatic biliary dysgenesis. This association of intrahepatic biliary dysgenesis and vascular malformations is postulated to be a specific malformation syndrome resulting most probably from intrauterine infection. The cardiovascular disease is usually mild. The liver dysfunction varies in severity, and is accompanied by a notable hyperlipoproteinemia with secondary xanthomata which can be ameliorated by long-term treatment with cholestyramine resin and/or vegetable oil supplements.

Child, Preschool↗

PubMed1998

Cholecystectomy in cardiothoracic organ transplant recipients.

OBJECTIVES: To assess the risks associated with cholelithiasis and cholecystectomy in cardiothoracic organ transplant recipients at this hospital and to identify any differences with potential causal significance between the group with known gallstones and the transplant recipient group as a whole. DESIGN: Medical records survey. SETTING: Tertiary care university hospital. PATIENTS: Six hundred forty-five patients had cardiothoracic organ transplantation at this hospital between February 1, 1984, and May 31, 1996. Gallstones were detected in 37 (5.7%) of these patients and 32 patients underwent cholecystectomy, of which 29 operations were performed primarily for symptomatic gallstone disease. All cholecystectomies were performed after transplantation. MAIN OUTCOME MEASURES: Mortality, morbidity, postoperative biliary disease. RESULTS: Patients with gallstones were significantly older than the transplant patient group as a whole (Student t test, P=.001); they were more likely to be female (chi2 test, P=.05); and they had a higher body mass index (t test, P=.001). There were no significant differences in the maximum serum bilirubin level during the transplantation admission, incidence of diabetes mellitus, cholestyramine use, or cyclosporine dosage during the first 12 months after transplantation. Cholecystectomy was performed after a median 5-month symptomatic period, mostly by the minilaparotomy method. Forty-five percent of cholecystectomies were urgent or semi-urgent. One patient died of lung infection on the second postoperative day. The median postoperative stay was 3 days. At a median 33 months' follow-up, 4 patients have had further biliary problems (2 patients with common bile duct stones, 1 patient with intrahepatic stones, and 1 patient with biliary dyskinesia). Four other patients with asymptomatic gallstones who did not receive cholecystectomy have remained asymptomatic for between 15 and 67 months. CONCLUSIONS: Cholecystectomy by the minilaparotomy or laparoscopic methods, with routine operative cholangiography, is the preferred treatment for symptomatic gallstones in cardiothoracic organ transplant recipients. Although the optimum management of asymptomatic gallstones in these patients remains unclear, our favorable experience with a policy of reserving cholecystectomy for symptomatic cases seems noteworthy.

Adolescent↗

PubMed1979

The effect of bile acids on colonic myoelectrical activity.

The effect of different concentrations of sodium cholate, sodium chenodeoxycholate and sodium deoxycholate on colonic myoelectrical activity was studied in 4 dogs. There was no statistically significant difference in percentage motility, motility index, basal pressure or mean slow wave frequency with either cholic or chenodeoxycholic acid (5--15 mM). Deoxycholic acid (15 mM), however, caused a marked increase in percentage motility (median control value 4.1, range 0--23; after installation, median value 27--0, range 20.6--45.0, P less than 0.001). This was accompanied by an increase in spike activity, but no alteration in mean slow wave frequency or basal pressure was seen. Cholestyramine inhibited the motor response. It appears that only deoxycholic acid affects both motility and absorption, presumably by different pathways, and may thus assume importance in disorders of colonic motility.

Action Potentials↗

PubMed1994

Dyslipidemia and coronary artery disease.

Genetically determined and metabolically induced disturbances in lipid metabolism, as manifested in several types of dyslipidemia, have been shown to be causally related to the development of coronary artery disease (CAD). A diversity of clinical and angiographic studies has been made to evaluate the linkage between plasma lipid-control therapy in the development of initial and recurrent cardiovascular events. The plan of treatment invariably begins with a low-fat, low-cholesterol diet before initiation of drug therapy. However, many patients have difficulty in adhering to the low-fat diet. Fortunately, metabolic studies show that foods which contain fats rich in stearic (saturated) and oleic (monounsaturated) fatty acids may be given in limited amounts to boost patients' compliance to a low-fat diet and to prevent their blood lipids from rising to abnormal levels. A bile acid sequestrant (cholestyramine or colestipol) is the first-line drug for control of hypercholesterolemia. Either gemfibrozil or gemfibrozil plus niacin is prescribed to raise high-density lipoprotein (HDL) levels of CAD patients. Approval of two HMG CoA reductase inhibitors, pravastatin and simvastatin, by the FDA gives physicians the additional flexibility of employing a single or a combination drug therapy for optimal control of dyslipidemia. The association of low serum cholesterol level (< 160 mg/dl) with increase in noncardiac mortality has prompted health professionals to consider modifying the universal screening and treatment of serum cholesterol in children and young women and to use hypolipidemic drugs in patients judiciously.

Arteriosclerosis↗

PubMed1997

Intrahepatic cholestasis of pregnancy: a French prospective study.

The aim of this prospective study was to analyze the characteristics of intrahepatic cholestasis of pregnancy (ICP) in a French population. From 1989 to 1995 we studied 50 consecutive pregnant women with ICP (41 single, 7 twin, and 2 triplet pregnancies) referred for hepatologic consultation. All patients suffered from pruritus and/or jaundice associated with elevated fasting serum levels of total bile acids (mean 49 micromol/L, range 7-290). No patients had concomitant liver disease and all recovered normal liver function after delivery. Overall prematurity rate was 60%: 100% in multiple pregnancies and 41% in single pregnancies. Three of 61 babies died. Systematic clinical interviews revealed that 34 patients had been treated with oral micronized natural progesterone (200-1,000 mg/d) during the current pregnancy for risk of premature delivery, including at least 32 (64%) before the onset of pruritus. Onset of pruritus was statistically earlier in patients previously receiving progesterone than in patients not receiving progesterone (217 +/- 21 vs. 240 +/- 26 days, P < .01). This was also found in the single pregnancy subgroup of patients (222 +/- 19 vs. 240 +/- 26 days, P < .05). Pruritus disappeared before delivery in 10 of 50 patients, i.e., after withdrawal of progesterone in 7 patients (only one concurrently treated with cholestyramine), after decrease in dose of progesterone in 1 patient, and spontaneously in 2 patients. During the same period, the percentage of pregnant women without ICP who had been treated with progesterone during pregnancy was statistically lower than the percentage of patients treated with progesterone before the onset of pruritus in our group of patients with ICP (36% vs. 64%, P < .01, odds ratio 3.16, 95% CI:1.29-7.80). These results suggest that orally administered progesterone might be an exogenous factor which triggers ICP in predisposed women.

Adolescent↗

PubMed1990

Dietary fiber for reducing blood cholesterol.

Soluble dietary fiber, including psyllium, has been shown to have mild to modest cholesterol lowering properties. Psyllium hydrophilic mucilloid (Metamucil, Procter and Gamble, Cincinnati, OH), a bulk laxative, when used as a dietary supplement in combination with a low fat diet, can lower total serum cholesterol and low-density lipoprotein (LDL) cholesterol, and raise high-density lipoprotein (HDL) cholesterol in hypercholesterolemic patients. The cholesterol lowering effects of psyllium are much less evident than those observed with cholestyramine and the HMG-CoA reductase inhibitors. The mechanism for the cholesterol lowering effect of psyllium is not known. The substance is well tolerated with long-term use.

Cholesterol↗