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Chenodeoxycholic acid(CDCA) in the clinical application of adverse reactions mainly to increase ALT, diarrhea and liver toxicity. The reason is that CDCA in the role of intestinal bacteria into stone acid, stone cholic acid is a liver toxic substances, diarrhea is because the bile salt inhibition of water and electrolyte absorption, increased water and electrolyte secretion. Studies have suggested that CDCA and other cholic acid detergency, can interfere with the biofilm lipid composition, induced destruction of liver cell membrane, resulting in liver toxicity, can also induce liver cell apoptosis. 
The cytoprotective effect of UDCA is primarily beneficial for hepatocytes and bile duct cells, and this protection is achieved in competition with chenodeoxycholic acid. First UDCA is a hydrophilic bile acid, with no significant "detergency", thus helping to protect the phospholipid-rich cell membrane from hydrophobic bile acids such as chenodeoxycholic acid damage. CDCA, can cause apoptosis and cause severe liver injury, and eventually develop into cirrhosis. And UDCA can inhibit the bile acid-induced bile duct epithelial cells and liver parenchymal cell apoptosis process, inhibit the pathological process of cirrhosis. UDCA competitively replaces toxic bile acid molecules on cell membranes and organelles, preventing direct damage to toxic liver cells by toxic bile acids. UDCA competitively inhibits the absorption of endogenous hydrophobic bile acids in the ileum, making UDCA a major bile acid in serum and bile, inhibiting hydrophobic bile acid-induced hepatocyte apoptosis and necrosis.

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