Skin surface bile acid contents in patients with hepatobiliary diseases and their relathinship to pruritus

Abstract

1. In this study relation of skin bile acid content or serum bile acid level to the pruritus in patients with hepatobiliary diseases were studied.
2. Skin surface bile acids of 19 patients (10 non-pruritics, 7mild pruritics and 2 severe pruritics) were fractionated according to their mode of conjugation by using Sephadex LH-20 and PHP-LH-20, and analyzed by gas-liquid chromatography, while total bile acid concentration in fasting serum was measured by enzymatic method.
3. There were no differences in the bile acid concentration and composition of skin surface or serum bile acid level between the groups with pruritus and that without pruritus.
4. However, the bile acid content of skin surface increased nearly to that of serum bile acid and the correlation coefficiency was 0.606 (p<0.05).
5. The increased bile acid on the skin surface in patients with hepatobiliary diseases was mainly composed of free chenodeoxycholic acid.
6. These findings suggest that bile acids do not play a causative role in the pruritus of the patients with cholestatic liver diseases.