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que no puede ser conjugado, se secreta en la bilis, se         11. Ramachandran R, Kakar S. Histological patterns in
reabsorbe por los colangiocitos y vuelve al hígado. Esta            drug-induced liver disease. Journal of clinical
circulación cole-hepática conduce a un aumento de                   pathology 2009;62:481-492.
bicarbonato en la bilis e induce hipercoleresis. De este
modo, el norUDCA revierte la colangitis esclerosante en el     12. Begriche K, Massart J, Robin MA, Borgne-Sanchez A,
modelo Mdr2-/- (ABCB4) de colangiopatía (73). Por                   Fromenty B. Drug-induced toxicity on mitochondria
último, el ácido obeticolico (OCA, 6ethyl-CDCA o INT-               and lipid metabolism: mechanistic diversity and
747) es un agonista potente y selectivo del FXR (74). En            deleterious consequences for the liver. Journal of
estudios con animales, el OCA aumenta la sensibilidad a la          hepatology 2011;54:773-794.
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también tiene propiedades anti-inflamatorias y anti-           13. Aires CC, Ijlst L, Stet F, Prip-Buus C, de Almeida IT,
fibróticas (74). En estudios clínicos de pacientes con CBP,         Duran M, et al. Inhibition of hepatic carnitine
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                                                               14. Fromenty B, Pessayre D. Inhibition of mitochondrial
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    La esteatosis y la colestasis por fármacos son el
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      @Real Academia Nacional de Farmacia. Spain
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