Role of UDCA/TUDCA in Mast Cell Disease?

[Remy]

I wrote a post on the benefits of TUDCA here to help correct protein misfolding and ER stress.

But now I'm reading that some mast cell patients are prescribed ursodiol (UDCA) to manage mast cell reactions caused by bile. I'm not sure I understand how exactly that works though...does anyone else know?

From what I can find, some bile acids seem to be secretory and others are non-secretory. The secretory ones can cause diarrhea. Taking TUDCA/UDCA changes the composition of the bile acids to a less toxic version and may help reduce diarrhea. But I'm still not entirely clear how all that ties into the mast cells yet.

TUDCA has been studied and found equivalent to UDCA in one to one doses. It may also be more tolerable than UDCA. And it's non-prescription, go figure.

And FWIW, UDCA has also been studied as a cell membrane stabilizer useful in some central nervous system disorders. It's also used for it's immunomodulatory action in AIDS patients.

Starting to wonder why this benign drug isn't a first line treatment for ME/CFS and MCAS...

 

[Who Me?]

So do we want it or not and does if it doesn't cause diahrea (which might be a bonus for me) does it make constipation worse?

I remember reading about this before and meant to add it to my tbd list.

 

[Remy]

 

[Who Me?]

What language is that? I don't read Martian. Lol

 

[Veet]

I've been following along this very long thread. TUDCA is central to the conversation, but this is the first time I've seen references to mast cells, as far as I can recall. Due to the higher cost of TUDCA, I requested an rx from my GP for UDCA, but never bothered to fill it and give it a try, as I'm not having overt gb issues. You've just given me more incentive.

 

[Who Me?]

The cost is why I didn't get any. I remember that thread well. I like the red warning "Do it at your own risk." Isn't that with everything we do? @Veet

 

[Remy]

I've been following along this very long thread. TUDCA is central to the conversation, but this is the first time I've seen references to mast cells, as far as I can recall. Due to the higher cost of TUDCA, I requested an rx from my GP for UDCA, but never bothered to fill it and give it a try, as I'm not having overt gb issues. You've just given me more incentive.

Do it! You can be the guinea this time...

 

[Remy]

So here's more...looks like it modulates the eosinophils, which may act similarly to the mast cells.

You can see your eosinophil count on a typical CBC. You want this to be 2-3% and elevations above this may indicate allergic disease.

Ursodeoxycholic acid suppresses eosinophilic airway inflammation by inhibiting the function of dendritic cells through the nuclear farnesoid X receptor.

Willart MA, et al. Allergy. 2012.
Show full citation
Abstract

BACKGROUND: Ursodeoxycholic acid (UDCA) is the only known beneficial bile acid with immunomodulatory properties. Ursodeoxycholic acid prevents eosinophilic degranulation and reduces eosinophil counts in primary biliary cirrhosis. It is unknown whether UDCA would also modulate eosinophilic inflammation outside the gastrointestinal (GI) tract, such as eosinophilic airway inflammation seen in asthma. The working mechanism for its immunomodulatory effect is unknown.

METHODS: The immunosuppressive features of UDCA were studied in vivo, in mice, in an ovalbumin (OVA)-driven eosinophilic airway inflammation model. To study the mechanism of action of UDCA, we analyzed the effect of UDCA on eosinophils, T cells, and dendritic cell (DCs). DC function was studied in greater detail, focussing on migration and T-cell stimulatory strength in vivo and interaction with T cells in vitro as measured by time-lapse image analysis. Finally, we studied the capacity of UDCA to influence DC/T cell interaction.

RESULTS: Ursodeoxycholic acid treatment of OVA-sensitized mice prior to OVA aerosol challenge significantly reduced eosinophilic airway inflammation compared with control animals. DCs expressed the farnesoid X receptor for UDCA. Ursodeoxycholic acid strongly promoted interleukin (IL)-12 production and enhanced the migration in DCs. The time of interaction between DCs and T cells was sharply reduced in vitro by UDCA treatment of the DCs resulting in a remarkable T-cell cytokine production. Ursodeoxycholic acid-treated DCs have less capacity than saline-treated DCs to induce eosinophilic inflammation in vivo in Balb/c mice.

CONCLUSION: Ursodeoxycholic acid has the potency to suppress eosinophilic inflammation outside the GI tract. This potential comprises to alter critical function of DCs, in essence, the effect of UDCA on DCs through the modulation of the DC/T cell interaction.

 

[Who Me?]

@Veet

 

[Issie]

I've tried it. One brand was better than another. I react to food dyes and one has red capsules. Was not good. The other one was. I don't know if it helped MCAS or not. I'm having a bad case of it. Got triggered by MMS. That was not a good experiment. Maybe will try it again.
Issie

 

[Remy]

I've tried it. One brand was better than another. I react to food dyes and one has red capsules. Was not good. The other one was. I don't know if it helped MCAS or not. I'm having a bad case of it. Got triggered by MMS. That was not a good experiment. Maybe will try it again.
Issie

I know! I was so pissed when I got those red caps! The Chizled brand (barf) is white.

I'm ready to go to UDCA though because it's a cheaper rx than TUDCA is a supplement.