Bile acid detoxification by nuclear receptor-mediated CYP3A regulation

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Liver diseases in which there is obstruction to bile flow (cholestatic liver diseases) can lead to liver failure, liver cirrhosis as well as a diminished quality of life. Patients suffer from severe itching which may prove difficult to control. It is thought that many of these adverse effects of obstructed bile flow are due to the retention of a component of bile, called bile acids, within the body. Bile acids are detergent-like compounds formed from cholesterol. Some bile acids are highly toxic and cause the death of cells in the liver if their concentration becomes too high. Evidence has emerged that the body has control mechanisms to try and combat rising levels of bile acids in cholestatic liver diseases. One such mechanism, which is the subject of this application, is the metabolism of bile acids to less toxic forms, by a process called hydroxylation. A particular class of liver enzymes, known as cytochromes P450 CYP3As, appear to mediate these hydroxylation reactions. Liver cytochrome P450 enzymes are important to medicine in areas as broad as drug breakdown, steroid hormone regulation and the formation or elimination of cancer causing chemicals. These enzymes are present in high concentration in the human liver, but the factors governing how much of these enzymes are produced have been poorly understood. The present projects builds on discoveries concerning the regulation of cytochrome P450 enzymes made by our group over the last few years, including an in-depth understanding of the way the production of CYP3As are increased by some drugs. We intend to determine the mechanism by which bile acids increase the level of CYP3A enzymes are how effective these enzymes are in hydroxylating bile acids. An understanding of these issues will allow us to better manage patents with cholestatic liver diseases and develop new strategies for treating these diseases, for example, development of novel drugs that increase bile acid hydroxylation in the liver.