Erapy of cholesterol gallstones can be regarded as primary or secondary. The purpose of primary prevention should be to avoid the formation of cholesterol gallstones both within the common population at higher risk for gallstones and in some epidemiologically identified highrisk ethnic groups. The purpose of secondary prevention should be to avert the recurrence of gallstones after dissolution therapy. Of note, many gallstones are silent while one third sooner or later causes symptoms and complications. Hence, secondary prevention can also be applied to prevent the development of symptoms and complications in such a subgroup of patients. Indeed, statins and ezetimibe can protect against dietinduced gallstones and promote gallstone dissolution in mice and prairie dogs. Also, their therapeutic effects happen to be proved in part in individuals with cholesterol gallstones. To evaluate remedy time, response price and overall costbenefit evaluation, a additional detailed, longterm human study is necessary. If powerful major and secondary prevention of cholesterol gallstones becomes a reality, then the possible could exist for the prevalence of gallstones along with the frequency of gallbladder surgery including open and laparoscopic cholecystectomies to substantially decline within the next handful of decades.NIHPA Author Manuscript NIHPA Author Manuscript NIHPA Author ManuscriptAcknowledgmentsWe are considerably indebted to Tony Y. Wang for preparing figures. This operate was supported in part by a analysis grant DK73917 (D.Q.H.W.) in the National Institutes of Wellness (US Public Overall health Service), the Saint Louis University Liver Center Seed Grant Award (D.Q.H.W.), the Saint Louis University President’s Analysis Fund (D.Q.H.W.), and Ministero dell’Istruzione, dell’Universite della Ricerca (MIUR) FIRB2003 and RBAU01RANB002, Fondazione Cassa di Risparmio di Puglia (Ricerca Scientifica e Tecnologica) (P.P.).AbbreviationsABC ACAT APO CSI HMGCoA NPC1L1 SRBI UDCA ATPbinding cassette transporter acylCoA:cholesterol acyltransferase apolipoprotein cholesterol saturation index 3hydroxy3methylglutarylCoA NiemannPick C1like 1 scavenger receptor class B form I ursodeoxycholic acid
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