Author: Dr. Lóránd Bertók Professor, Doctor of Medicine (MTA), honorary associate professor

Title: Defence mechanisms in the living world - The role of endotoxin in natural immunity

Place of appearance: Hungarian Science 2004/10 - page 1130

Under natural conditions - in certain pathological cases - endotoxin is always absorbed from the gut into the circulation and triggers pathological processes. Under natural conditions, however, bile acids protect the body against endotoxins that are always present in the gut by cleaving them into atoxic parts.
It also turns out that this protection also protects against all agents with a lipoid structure (e.g. large viruses with envelopes). This protection system, based on the detergent action of bile acids, has been called physico-chemical protection.
Weaker or stronger endotoxaemia due to bile deficiency may play a role in the development of several pathologies, such as septic shock, renal failure in patients with jaundice due to bile duct obstruction, intestinal ischaemia, burn shock, radiation sickness, some endocrine disorders, psoriasis, atherosclerosis, etc. Therefore, bile acids can be used effectively to prevent or treat some of these conditions (renal failure, psoriasis).
It has been shown that all the effects that damage the intestinal mucosa reduce or completely prevent the production of a peptide, cholecystokinin, in the absence of which the gallbladder cannot empty bile into the intestine, and in its partial absence endotoxins released from the decayed bacteria can be "absorbed" and, entering the circulation, cause endotoxemia, or in more severe cases shock.
The study of the physico-chemical defence based on the surfactant properties of bile acids, and the exploration of its details using modern methods, could be the basis for a new pathological approach, since it also addresses fundamental issues of cholesterol metabolism, since bile acids are largely recycled end products of this process.