Abstract
Previous studies of the bile acid composition of meconium and bile obtained in the first few days of life indicate that, compared to the adult, there are significant differences in the hepatic synthesis of bile acids. Analysis of human fetal gallbladder bile provides a more direct assessment of primary hepatic synthesis in utero, but only limited studies have been described. Using HPLC, GLC and mass speetrometry the bile acid composition was determined for fetal gallbladder bile obtained after legal abortion between the 14th and 20th weeks of gestation. Chenodeoxycholic and cholic acids were the major bile acids identified however the profiles were characterized by an array of metabolites not normally found in adult bile. Hyocholic acid levels often exceeded those of cholic acid indicating C-6 hydroxylation to be a major pathway for bile acid synthesis in early life. Bile acid concentrations were relatively low before week 17 of gestation but showed a significant surge thereafter, increasing by >10 fold by week 20. The ratio of chenodeoxycholic:cholic acid in bile was constant (0.85) over this period and much lower than for newborn bile and adult bile indicating an immaturity in hepatic 12α-hydroxylase in early development. These observations demonstrate that more than 50% of the bile acids are accounted for by atypical bile acids and that the profile resembles that found in adults with cholestasis. This may in part account for the physiologic cholestasis of the newborn.
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Setehell, K., Dumaswala, R., Colombo, C. et al. BILIARY BILE ACID EXCRETION BY THE HUMAN FETUS DURING EARLY GESTATION. Pediatr Res 21 (Suppl 4), 277 (1987). https://doi.org/10.1203/00006450-198704010-00660
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DOI: https://doi.org/10.1203/00006450-198704010-00660