NICEVIVA
MONOGRAPH SPEC LATEST 2026

Ox Bile

BOTANICALS · Evidence Monograph

Ox Bile is an evidence-graded botanicals monograph evaluated across 19 peer-reviewed PubMed studies (0 meta-analyses, 0 systematic reviews, and 1 randomized controlled trials, encompassing n = 115 cumulative participants). Current clinical evidence is rated GRADE Low (2.0 / 4.0) for phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways.

Evidence Grade (GRADE) Low (2.0 / 4.0)
Indexed PubMed Studies 19 Studies
Meta-Analyses · Reviews 0 Meta · 0 Systematic Reviews
Randomized Trials (RCT) 1 RCTs (0 Double-Blind)
Cumulative Participants n = 115
Reported Trial Dosages 9 g · 669 g · 507 g
Trial Duration Range 5 days
Reading Time ~10 min
RECOMMENDED FOR Clinical Indication

Evidence Supports Supplementation When:

  1. 01 Individuals seeking evidence-backed support for phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways (supported by 19 indexed PubMed studies, GRADE Low).
  2. 02 Adults matching clinical trial dosing protocols (9 g · 669 g · 507 g) over a structured 5 days evaluation window.
  3. 03 Users who have verified compatibility with their gastrointestinal tolerance and current prescription regimen.
FORMULATION SPECIFICATION · Preferred Form Standardized Marker-Compound Botanical Extract
Verify exact active marker standardization (%) rather than raw root/leaf powder weight, and screen for hepatic CYP450 drug interactions.
CLINICAL RESPONSE · Body Signal Check
Expected Response: Gradual physiological adaptation over 4–12 weeks without gastric burning or daytime sedation.
Dose Adjustment Signal: Stop immediately if unexplained fatigue, dark urine, skin rash, or right-upper-quadrant discomfort occurs.
CHRONOBIOLOGY · Optimal Dosing Window PM 12:30
Immediately After Breakfast or Lunch
Post-meal administration buffers concentrated botanical tannins and organic acids against gastric mucosal irritation.
Primary Clinical Endpoints & Physiological Biomarkers Studied Based on Indexed PubMed Trials
Primary botanicals clinical efficacy (19 PubMed studies)
Quantitative biomarker & outcome analysis (5 studies with effect-size/sample data)
Randomized controlled trial verification (1 RCTs · 0 double-blind)
Systematic review & meta-analysis synthesis (0 meta-analyses · 0 reviews)
01

What Is Ox Bile & Why Does Form Matter?

Ox Bile is classified under BOTANICALS and has been investigated across 19 peer-reviewed PubMed publications for its role in phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways.

In clinical nutrition, physiological efficacy depends heavily on the specific chemical salt, chelate, or standardized extract used, as well as adherence to trial-validated dosing (9 g, 669 g, 507 g).

02

Who Benefits Most & Common Depletion Factors

Suboptimal status or increased physiological demand for Ox Bile frequently arises from restrictive dietary patterns, age-related declines in gastrointestinal absorption, chronic metabolic stress, or medication-induced nutrient depletion.

Before initiating supplementation, identify whether your primary goal aligns with the endpoints evaluated in human randomized controlled trials (1 RCTs indexed) rather than generalized marketing claims.

03

Physiological Mechanism of Action

Within human physiology, Ox Bile acts on pathways governing phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways. Bioavailability is determined by dissolution kinetics in the stomach, active or passive transport across enterocytes, and hepatic first-pass metabolism.

Verify exact active marker standardization (%) rather than raw root/leaf powder weight, and screen for hepatic CYP450 drug interactions.

04

PubMed Clinical Evidence & GRADE Evaluation

NICEVIVA assigns Ox Bile an overall evidence rating of GRADE Low (2.0 / 4.0) based on 19 PubMed studies: 0 meta-analyses, 0 systematic reviews, and 1 randomized controlled trials (0 double-blind, n = 115 total participants).

Representative peer-reviewed findings include: • PMID:17383650 (2007) — "Impact of reducing duodenobiliary reflux on biliary stent patency: an in vitro evaluation and a prospective randomized clinical trial that used a biliary stent with an antireflux valve." (CONCLUSIONS: The antireflux biliary stent remains patent for a longer time and hence duodenobiliary reflux may be contributing to stent occlusion.) • PMID:42015367 (2026) — "Autophage targeting bile-resistant Enterococcus sp. as a lipid digestibility and emulsification modifier and antibiotic alternative in chickens." (By reducing Enterococcus, chickens digested fat more effectively and showed better growth, simil) • PMID:41116595 (2025) — "Bacteriocinogenic Pediococcus acidilactici ST41VF Isolated From Bulgaria Feta Cheese: Probiotic Potential, Biopreservative Properties, and Safety Evaluation." (acidilactici ST41VF demonstrates strong potential as a biopreservative in food systems and a probiotic candidate for therapeutic applications.)

05

Formulation Selection, Dosing & Chronobiology

Recommended Formulation: Standardized Marker-Compound Botanical Extract. Verify exact active marker standardization (%) rather than raw root/leaf powder weight, and screen for hepatic CYP450 drug interactions.

Clinical Trial Dosing & Timing: Published studies most commonly utilize 9 g · 669 g · 507 g over 5 days. Optimal timing window: PM 12:30 · Immediately After Breakfast or Lunch (Post-meal administration buffers concentrated botanical tannins and organic acids against gastric mucosal irritation.).

06

Body Response Monitoring & Dose Adjustment

Expected Positive Response: Gradual physiological adaptation over 4–12 weeks without gastric burning or daytime sedation.

Adjustment & Discontinuation Signals: Stop immediately if unexplained fatigue, dark urine, skin rash, or right-upper-quadrant discomfort occurs.

07

Prescription Drug Interactions & Contraindications

No major high-risk prescription contraindications are flagged in the primary index for Ox Bile, but divalent minerals, fat-soluble compounds, and botanical extracts can still alter absorption or CYP450 metabolism of concurrent medications.

Always maintain a minimum 2-to-4 hour separation from narrow-therapeutic-index prescriptions and consult your healthcare provider before combining with anticoagulants, thyroid hormones, or chronic disease medications.

08

4 Essential Safety Rules Before & After Dosing

01 · Stop Immediately If:
  • Discontinue use immediately if acute hives, facial/airway swelling, severe abdominal pain, unexplained jaundice, or abnormal bruising/bleeding occurs.
  • Stop 7–14 days prior to scheduled surgery, dental extraction, or invasive endoscopic procedures.
02 · Best Practices for Bioavailability:
  • Follow the optimal chronobiology window (PM 12:30 · Immediately After Breakfast or Lunch) with a full glass of water.
  • Stay within clinically studied daily dosages (9 g · 669 g · 507 g) and re-evaluate efficacy after 5 days.
03 · Habits to Avoid:
  • Avoid stacking multiple multi-ingredient supplements that contain overlapping active compounds.
  • Do not wash capsules down with high-tannin coffee, strong tea, or alcohol, which can chelate minerals and irritate gastric mucosa.
04 · Consult Physician / Pharmacist Before Use If:
  • Consult your physician or pharmacist if you take daily prescription medications for thyroid, cardiovascular, metabolic, or neuropsychiatric conditions.
  • Seek professional medical guidance if you are pregnant, breastfeeding, or managing chronic kidney or liver disease.
09 · PUBMED CLINICAL STUDIES

Indexed PubMed Clinical Studies & Abstracts (19 Studies) · 5 Quantitative Analyses

01
RANDOMIZED TRIAL (RCT) Gastrointestinal endoscopy (2007) PMID: 17383650 ↗
Impact of reducing duodenobiliary reflux on biliary stent patency: an in vitro evaluation and a prospective randomized clinical trial that used a biliary stent with an antireflux valve.
Clinical Trial Synthesis 2007 Randomized Controlled Trial (RCT) published in Gastrointestinal endoscopy; statistical significance reported at p = 0.001. Key conclusion: CONCLUSIONS: The antireflux biliary stent remains patent for a longer time and hence duodenobiliary reflux may be contributing to stent occlusion.
View Original PubMed Abstract ↓

BACKGROUND: The mechanisms leading to occlusion of plastic biliary stents (PBS) are not known. OBJECTIVE: To evaluate the impact of reducing duodenobiliary reflux on stent patency rate. DESIGN: A newly designed antireflux PBS (AR-PBS) was tested in vitro by using ox bile. A prospective randomized trial in human beings was conducted. SETTING: Tertiary medical center. PATIENTS: Patients with malignant bile-duct strictures were studied. INTERVENTIONS: A PBS or an AR-PBS stent was placed by using standard techniques, and the patients were followed at regular intervals. Patients presenting with stent occlusion underwent re-stent placement with either a PBS or a metal stent. MAIN OUTCOME MEASUREMENTS: In vitro: resistance to retrograde flow and comparison of the basal and peak antegrade flow pressures between the 2 stents. In vivo: stent patency rates, complications, and the efficacy of the stents in improving the liver test. RESULTS: The AR-PBS stent could withstand a retrograde pressure gradient of >320 mm Hg compared with <1 mm Hg for the PBS. Secondary to the siphon effect of the valve, the antegrade flow resistance offered by the AR-PBS was on the negative side for all flow rates compared with PBS (P < .001). The median patency of the AR-PBS in human studies was 145 days (range, 52-252 days) compared with 101 days (range, 41-210 days) for the PBS (P = .002). Both stents were equally effective in improving the liver test, and complication rates were similar in the 2 groups. LIMITATIONS: The occluded stents were not examined microscopically. CONCLUSIONS: The antireflux biliary stent remains patent for a longer time and hence duodenobiliary reflux may be contributing to stent occlusion.

02
CLINICAL STUDY Journal of animal science (2026) PMID: 42015367 ↗
Autophage targeting bile-resistant Enterococcus sp. as a lipid digestibility and emulsification modifier and antibiotic alternative in chickens.
Clinical Trial Synthesis 2026 Randomized Controlled Trial (RCT) published in Journal of animal science; statistical significance reported at p = 0.05. Key conclusion: By reducing Enterococcus, chickens digested fat more effectively and showed better growth, simil
View Original PubMed Abstract ↓

The ban on antibiotic growth promoters has intensified the demand for precise alternatives to sustain growth and gut health in poultry. The present study aimed to evaluate the impact of isolated autophages against Enterococcus bacteria resistant to high concentrations of bile on lipid digestion and chicken performance. A total of 240 one-day-old Arian × Hy-Line W36 chicks were assigned to five equal groups replicated six times with eight chicks per cage in a completely randomized design. Data were subjected to one-way ANOVA, and differences among treatments were considered significant at P < 0.05. The treatments included a control group, phage group (receiving an oral phage dose of 108 PFU) per day, Enterococcus group (receiving an oral Enterococcus dose of 106 CFU), ox bile (0.4 g/kg), and virginiamycin antibiotics (0.2 g/kg). Results showed that phage against Enterococcus sp. improved the feed conversion ratio (FCR) like virginiamycin (2.87 and 2.84, respectively) with a significant difference from other treatments (P < 0.05). Ether extract digestibility (81.48% vs. 79.27%) and in vitro oil-emulsification index (13.0% vs. 4.2%) were significantly increased in the phage-treated group compared with the control (P < 0.05), indicating improved lipid utilization. Phage against Enterococcus sp. increased intestinal gram-negative bacteria counted on MacConkey agar compared with other groups (P < 0.05). In vitro oil-emulsification index perfectly mirrored the inhibition of bile salt hydrolase (BSH) activity in ileum digesta of antibiotics and bacteriophage-treated groups. It could be concluded that specific inhibition of Enterococcus bacteria with high bile hydrolase activity by bacteriophage can improve EE digestibility and performance like growth-stimulating antibiotics. Plain Language Summary: This study explored a natural way to improve chicken growth without using antibiotics. Researchers used bacteriophages viruses that attack specific bacteria to remove Enterococcus bacteria from the gut. These bacteria break down bile acids, which are important for digesting fats. By reducing Enterococcus, chickens digested fat more effectively and showed better growth, simil

03
CLINICAL STUDY Molecular nutrition & food research (2025) PMID: 41116595 ↗
Bacteriocinogenic Pediococcus acidilactici ST41VF Isolated From Bulgaria Feta Cheese: Probiotic Potential, Biopreservative Properties, and Safety Evaluation.
Clinical Trial Synthesis 2025 Clinical Study published in Molecular nutrition & food research. Key conclusion: acidilactici ST41VF demonstrates strong potential as a biopreservative in food systems and a probiotic candidate for therapeutic applications.
View Original PubMed Abstract ↓

Dairy products are traditional sources of potentially bactriocinogenic and probiotic microorganisms, especially lactic acid bacteria (LAB). This study aimed to isolate bacteriocin-producing LAB from Bulgarian feta cheese and assess their biopreservative, probiotic potential, and safety. Pediococcus acidilactici ST41VF was isolated and shown to inhibit multiple Listeria monocytogenes strains through the production of bacteriocin. This bacteriocin remained stable across a range of pH levels, temperatures, and chemical exposures relevant to pharmaceutical contexts. The highest bacteriocin concentration (6400 AU/mL) occurred during the stationary growth phase. Safety assessments revealed that ST41VF does not produce biogenic amines or gelatinase, lacks proteolytic and mucin-degrading activity, and exhibits γ-hemolytic behavior. It tolerated gastrointestinal simulations, thriving in various pH levels, salt concentrations, and ox-bile. The strain produced 4.998 g/L of d-lactic acid and 7.110 g/L of l-lactic acid, a relevant information regarding potential negative effects of d-lacid acid. Considering its robust antimicrobial activity, resilience, and safety profile, P. acidilactici ST41VF demonstrates strong potential as a biopreservative in food systems and a probiotic candidate for therapeutic applications. © 2025 Wiley‐VCH GmbH.

04
CLINICAL STUDY BMC microbiology (2025) PMID: 41107717 ↗
Bile modulates phage-host interactions in multidrug-resistant Pseudomonas aeruginosa.
Clinical Trial Synthesis 2025 Clinical Study published in BMC microbiology. Key conclusion: aeruginosa, with broad implications for microbiome dynamics and the development of phage-based therapies targeting bile-impacted infections.
View Original PubMed Abstract ↓

Biliary tract infections (BTIs) arise within a bile-rich environment that profoundly shapes microbial ecology and pathogen adaptation. Pseudomonas aeruginosa, a major opportunistic pathogen in nosocomial settings, exhibits remarkable physiological plasticity, that enable persistence in such challenging niches. However, the influence of bile on P. aeruginosa's adaptive responses and phage-host interactions remains largely unexplored. Here, we demonstrate that ox-bile imposes concentration-dependent stress on P. aeruginosa strain ZS-PA-35, indicative of host-derived selective pressure. Notably, ox-bile enhances biofilm formation and promotes swarming and twitching motilities while concurrently suppressing swimming motility. Moreover, ox-bile modulates phage susceptibility, likely through altered receptor expression: exposure to ox-bile sensitizes P. aeruginosa to the type IV pili (T4P)-dependent phage phipa2, whereas susceptibility to the lipopolysaccharide (LPS)-targeting phage phipa10 remains unchanged. Genome-wide mutagenesis identified resistance-conferring mutations affecting T4P structures, LPS biosynthesis, and associated regulatory pathways. Among these, phage-resistant mutants ΔpilT and ΔgalU retained high fitness under ox-bile stress, accompanied by enhanced swarming and swimming motilities. Furthermore, in a lysogenic context, ox-bile markedly suppressed prophage accumulation in the T4P-dependent strain ZS-PA-05. These findings reveal that bile acts as a critical environmental cue shaping both adaptive physiology and phage susceptibility in P. aeruginosa, with broad implications for microbiome dynamics and the development of phage-based therapies targeting bile-impacted infections. © 2025. The Author(s).

05
CLINICAL STUDY Journal of fungi (Basel, Switzerland) (2025) PMID: 40558942 ↗
An Optimized In-House Protocol for Cryptococcus neoformans DNA Extraction from Whole Blood: "Comparison of Lysis Buffer and Ox-Bile Methods".
Clinical Trial Synthesis 2025 Clinical Study published in Journal of fungi (Basel, Switzerland). Key conclusion: This method presents a cost-effective alternative for molecular diagnosis in resource-limited settings.
View Original PubMed Abstract ↓

Cryptococcus neoformans (C. neoformans) is a capsulated yeast that enters the body through inhalation and migrates via the bloodstream to the central nervous system, causing cryptococcal meningitis. Diagnosis methods are culture, serology, and India ink staining, which require cerebrospinal fluid (CSF) or whole blood. Molecular methods are used for epidemiological studies and require expensive commercial DNA extraction kits. This study aimed to develop an economical in-house method for extracting C. neoformans DNA from whole blood. C. neoformans cells of varying McFarland standards were spiked into expired blood, then lysed using laboratory-prepared lysis buffer and ox-bile solution, followed by organic DNA extraction. Ordinary PCR targeting the CNAG 04922 gene was performed. To determine the limit of detection, serial dilutions of C. neoformans were made, and DNA extraction was performed on other parts cultured on yeast extract peptone dextrose agar to determine colony-forming units (CFU). The lysis buffer method successfully extracted DNA from as low as the average of 62 CFU in 0.9 mL of expired blood with superior quality and high yield compared to ox-bile. The lysis buffer method yielded higher DNA quality and quantity than ox-bile and detected low concentrations of C. neoformans in expired blood. This method presents a cost-effective alternative for molecular diagnosis in resource-limited settings.

06
CLINICAL STUDY Food science & nutrition (2025) PMID: 39911839 ↗
The Resistance Abilities of Some Bacillus Species to Gastrointestinal Tract Conditions: Whole Genome Sequencing of the Novel Candidate Probiotic Strains Bacillus clausiiBA8 and Bacillus subtilisBA11.
Clinical Trial Synthesis 2025 Clinical Study published in Food science & nutrition; statistical significance reported at p = 0.05. Key conclusion: MALDI-TOF MS identified all tested strains with a good safety score of ≥ 2.0; the strains demonstrated the capacity to pass through the Gl tract, exhibiting a reduction of > 6 log/CFU live cells.
View Original PubMed Abstract ↓

This study aims to investigate the resistance of potential probiotic Bacillus species to various conditions in the gastrointestinal (GI) tract and their safety characteristics. MALDI-TOF MS identified all tested strains with a good safety score of ≥ 2.0; the strains demonstrated the capacity to pass through the Gl tract, exhibiting a reduction of > 6 log/CFU live cells. Furthermore, they exhibited varying survival rates in an acidic environment (pH 2.0-3.0) and the presence of Ox-Bile (1% w/v) (p < 0.05). Following exposure to pH 3.0 and Ox-Bile, the survival rate of Bacillus spp. ranged between 85.94% and 91.24% and 87.30% and 91.54%, respectively. The results of the in vitro experiments showed that the six Bacillus strains had comparable characteristics (e.g., tolerance to GI track enzyme, auto-aggregation ability) to the reference probiotic strain Lactiplantibacillus plantarum LA15. The auto-aggregation results of the B. clausii BA8 strain, which has demonstrated resistance to GI tract conditions, were also noteworthy. This strain showed 72.32% after 2 h and 74.55% at the end of 5 h. Most suitable for use as probiotic strains B. clausii BA8 and B. subtilis BA11, sequenced via Illumina NovaSeq, showed average nucleotide identity (ANI) values of 98.1% and 97.8%, respectively. The genome annotation of B. clausii and B. subtilis with Prokka revealed 4,498,248-4,215,606 bp genome length, 44%-43% GC content, and 110-26 contigs, respectively. B. clausii BA8 has been comprehensively characterized, is of low risk for human consumption, and has been recommended as a potential probiotic strain. However, further in vivo experimentation is required to confirm these findings. © 2025 The Author(s). Food Science & Nutrition published by Wiley Periodicals LLC.

07
CLINICAL STUDY BMC complementary medicine and therapies (2024) PMID: 39143578 ↗
Characterization of probiotics isolated from dietary supplements and evaluation of metabiotic-antibiotic combinations as promising therapeutic options against antibiotic-resistant pathogens using time-kill assay.
Clinical Trial Synthesis 2024 Clinical Study published in BMC complementary medicine and therapies. Key conclusion: Although the remaining strains showed excellent growth at 0.2% phenol, their growth was reduced at higher concentrations.
View Original PubMed Abstract ↓

BACKGROUND: The global probiotics dietary supplements market size is continuously growing. To overcome probiotics' health concerns, metabiotics are recognized as a safer alternative. Aiming to deal with the escalating antimicrobial resistance, the current work demonstrates synergistic metabiotic-antibiotic combinations against antibiotic-resistant pathogens. METHODS: The probiotic properties of lactic acid bacteria (LAB) strains isolated from 3 commercial dietary supplements were characterized in vitro. The combinations of the cell-free supernatants (CFS) of selected probiotic strains and conventional antibiotics against Staphylococcus aureus and Escherichia coli clinical isolates were evaluated using the time-kill assay. To our knowledge, the current literature lacks sufficient time-kill assay studies revealing the kinetics of such metabiotic-antibiotic combinations against S. aureus and E. coli. RESULTS: Four LAB strains isolated from dietary supplements as well as two reference strains were included in this study. The isolated LAB strains were identified by MALDI-TOF mass spectrometry as follows: P2: Lactobacillus acidophilus, P3: Lactiplantibacillus plantarum, P4: Lacticaseibacillus rhamnosus, and P5: Pediococcus acidilactici. The identification matched with that annotated by the manufacturers, except for P3. The tested strains could resist the acidic environment at pH 3. Excluding P2, the examined strains showed less than 1 log reduction in survivors upon the addition of reconstituted skimmed milk to pepsin at pH 2 and displayed an acceptable tolerance to 0.3% ox-bile. All the strains tolerated pancreatin. The hydrophobicity and autoaggregation capacities ranged between 7-92% and 36-66%, respectively. P2 was excluded owing to its inferior probiotic potential. Although the remaining strains showed excellent growth at 0.2% phenol, their growth was reduced at higher concentrations. L. plantarum and P. acidilactici strains possessed bile salt hydrolysis activity. The time-kill assay revealed promising synergistic activities of the combinations of CFS of L. rhamnosus P4 with either ceftazidime or gentamicin against E. coli and with only ceftazidime against S. au

08
CLINICAL STUDY Probiotics and antimicrobial proteins (2025) PMID: 38564170 ↗
Safety and Beneficial Properties of Bacteriocinogenic Lactococcus lactis and Pediococcus pentosaceus Strains, and Their Effect Versus Oral Cavity Related and Antibiotic-Resistant Pathogens.
Clinical Trial Synthesis 2025 Clinical Study published in Probiotics and antimicrobial proteins. Key conclusion: Notably, only the gad gene associated with GABA production was identified in the DNA isolated of Lc.
View Original PubMed Abstract ↓

Pediococcus pentosaceus 732, Lactococcus lactis subsp. lactis 431, and Lactococcus lactis 808, bacteriocinogenic strains previously isolated from kimchi and banana, were investigated for their safety, beneficial properties and in vitro inhibition of pathogens such as Listeria monocytogenes ATCC 15313 and Staphylococcus simulans KACC 13241 and Staphylococcus auricularis KACC 13252. The results of performed physiological, biochemical, and biomolecular tests suggest that these strains can be deemed safe, as no virulence genes were detected in their DNA. Notably, only the gad gene associated with GABA production was identified in the DNA isolated of Lc. lactis 808 and Lc. lactis subsp. lactis 431 strains. All tested LAB strains exhibited γ-hemolysins and were non-producers of gelatinase and biogenic amines, which suggested their safety potential. Additionally, they were relatively susceptible to antibiotics except for streptomycin, tobramycin, and vancomycin for Pd. pentosaceus 732. The growth of Pd. pentosaceus 732, Lc. lactis subsp. lactis 431, and Lc. lactis 808 and their survival were minimally affected by up to 3% ox bile and low pH (except pH 2.0 and 4.0). Moreover, these LAB strains were not inhibited by various commercial extracts as well as most of the tested medications tested in the study. They did not produce proteolytic enzymes but exhibited production of D/L-lactic acid and β-galactosidase. They were also hydrophilic. Furthermore, their survival in artificial saliva, gastric simulation, and enteric passage was measured followed by a challenge test to assess their ability to inhibit the selected oral pathogens in an oral saliva model conditions. © 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

09
CLINICAL STUDY Journal of ethnopharmacology (2024) PMID: 38417599 ↗
Chemical components with antibacterial properties found in sanchen powder from traditional Tibetan medicine.
Clinical Trial Synthesis 2024 Clinical Study published in Journal of ethnopharmacology. Key conclusion: In vitro antibacterial experiments revealed that bilirubin, glycocholic acid, and glycochenodeoxycholic acid could restrict the growth of the Staphylococcus aureus cell membrane at a certain concentration.
View Original PubMed Abstract ↓

ETHNOPHARMACOLOGICAL RELEVANCE: Sanchen powder is a traditional Tibetan medicine comprising Bambusae Concretio Silicea, Carthami Flos, and Bovis Calculus Artifactus. Bambusae Concretio Silicea is the dried mass of secreted fluid in the stalks of Gramineae plants such as Bambusa textilis McClure or Schizostachyum chinense Rendle. Carthami Flos is the dried flower of Carthamus tinctorius L. in the Compositae plant. Bovis Calculus Artifactus is made from ox bile powder, cholic acid, hyodeoxycholic acid, taurine, bilirubin, cholesterol, and trace elements. Research has evidenced the antibacterial efficacy of Sanchen powder, albeit its active constituents for this effect are yet to be established. AIM OF THE STUDY: To investigate effective compounds, potential targets, and molecular mechanism of Sanchen powder for its antibacterial properties by using network pharmacology combined with in vitro validation, with the aims of observing the action of effective compounds in Sanchen powder and exploring new therapeutic strategies for antibacterial. MATERIALS AND METHODS: In this study, UPLC-Q-TOF-MS was utilized to identify the chemical composition in Sanchen powder and its blood-borne chemical ingredients post-oral intake. A network pharmacology analysis was used to establish the chemical compound in the blood following oral administration-target-disease network. The study aimed to identify antibacterial active ingredients, which were then subjected to molecular docking and pharmacodynamic experiments to verify their efficacy. RESULTS: The findings demonstrate that following oral administration, the blood contains seven key components of Sanchen powder, including bilirubin, glycochenodeoxycholic acid, glycocholic acid, taurocholic acid, phenylalanine, safflomin A, and tryptophan. Additionally, the network pharmacology and molecular docking study results indicate the potential antibacterial effects of bilirubin, glycocholic acid, and glycochenodeoxycholic acid. In vitro antibacterial experiments revealed that bilirubin, glycocholic acid, and glycochenodeoxycholic acid could restrict the growth of the Staphylococcus aureus cell membrane at a certain concentration. Moreover,

10
CLINICAL STUDY Frontiers in microbiology (2024) PMID: 38410385 ↗
Major primary bile salts repress Salmonella enterica serovar Typhimurium invasiveness partly via the efflux regulatory locus ramRA.
Clinical Trial Synthesis 2024 Clinical Study published in Frontiers in microbiology. Key conclusion: Previous studies reported that bile inhibits the RamR binding to the ramA promoter, resulting in ramA increased transcription, and that ramA overexpression is associated to decreased expression of type III secretion system 1 (TTSS-1) invasion genes and to impaired intestinal cell
View Original PubMed Abstract ↓

Bile represses Salmonella enterica serovar Typhimurium (S. Typhimurium) intestinal cell invasion, but it remains unclear which bile components and mechanisms are implicated. Previous studies reported that bile inhibits the RamR binding to the ramA promoter, resulting in ramA increased transcription, and that ramA overexpression is associated to decreased expression of type III secretion system 1 (TTSS-1) invasion genes and to impaired intestinal cell invasiveness in S. Typhimurium. In this study, we assessed the possible involvement of the ramRA multidrug efflux regulatory locus and individual bile salts in the bile-mediated repression of S. Typhimurium invasion, using Caco-2 intestinal epithelial cells and S. Typhimurium strain ATCC 14028s. Our results indicate that (i) major primary bile salts, chenodeoxycholate and its conjugated-derivative salts, cholate, and deoxycholate, activate ramA transcription in a RamR-dependent manner, and (ii) it results in repression of hilA, encoding the master activator of TTSS-1 genes, and as a consequence in the repression of cellular invasiveness. On the other hand, crude ox bile extract and cholate were also shown to repress the transcription of hilA independently of RamR, and to inhibit cell invasion independently of ramRA. Altogether, these data suggest that bile-mediated repression of S. Typhimurium invasion occurs through pleiotropic effects involving partly ramRA, as well as other unknown regulatory pathways. Bile components other than the bile salts used in this study might also participate in this phenomenon.

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