Sulfation of Bile Salts: A New Metabolic Pathway

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Abstract
Bile salt sulfates were first detected in 1967 by Palmer who realized that lithocholate in human bile is partially sulfated. Subsequently, sulfate esters of cholate and cheno-deoxycholate were identified in the serum and urine of patients with cholestasis. Sulfation of bile salts increases the solubility of these steroids in water and changes its metabolism, excretion, and toxicity. Sulfated bile salts are more rapidly excreted in the urine. Sulfated lithocholate is in addition less efficiently reabsorbed in the intestine than the non-sulfated compound. Furthermore sulfated bile salts seem to be less toxic than the non-sulfated molecules. Sulfation of lithocholate is an important metabolic pathway in normal man. In contrast sulfation of cholate, deoxycholate, and chenodeoxycholate only becomes quantitatively important in patients with cholestasis.

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