Ursodeoxycholic acid choleresis: Relationship to biliary HCO-3 and effects of Na+-H+ exchange inhibitors

The authors have recently shown that substitution of Li+ for perfusate Na+ eliminates the HCO3--rich choleresis produced by ursodeoxycholic acid (UDCA) in isolated perfused rat liver and that the increase in bile flow produced by both UDCA and taurocholic acid is partially inhibited by 1 mM amiloride. Although these findings are consistent with a role for Na+-H+ exchange in the choleresis produced by these bile acids, both Li+ substitution and amiloride affect other cellular processes, including Na+-K+-ATPase activity. They have now further explored both the relationship between UDCA-stimulated bile flow and biliary HCO3- secretion and the possible role of Na+-H+ exchange in this process by comparing the effects of amiloride with two of its more potent and presumably more specific analogues, 5-(N,N-dimethyl)amiloride hydrochloride (DMA) and 5-(N-ethyl-N-isopropyl)amiloride (EIA). None of the inhibitors significantly altered biliary UDCA output or the relationship between UDCA-induced bile flow and either biliary [HCO3-] or biliary HCO3- output. Effects of these inhibitors did not appear attributable either to nonspecific toxicity, as reflected by hepatic release of lactate dehydrogenase or K+, or to inhibition of hepatic Na+-K+-ATPase, measured as Na+-dependent uptake of 86Rb. These findings indicate that UDCA-induced but not basal bile formation is closely coupled to biliary HCO3- concentration and output, and they provide additional evidence that UDCA choleresis requires an intact Na+-H+ exchange mechanism