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Cholic Acid

Drugs and Chemicals · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed9 referencesApproximately 4 min read

A major primary bile acid produced in the liver and usually conjugated with glycine or taurine.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (812 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

A major primary bile acid produced in the liver and usually conjugated with glycine or taurine. It facilitates fat absorption and cholesterol excretion.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Cholbam.

Where it fits in the MeSH classification

Broader topics
Cholic Acids
Narrower topics
Cholates

Research landscape

PubMed indexes 2,253 records tagged with the MeSH heading “Cholic Acid” (counts retrieved 2026-10-31). 274 of them (12.2%) were published from 2020 onward, and the busiest period so far is through 1999 with 945 records.

Reviews account for 34 records (1.5%) and meta-analyses for 0. Randomized controlled trials number 22 (1.0%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.

PubMed records by publication periodthrough 1999: 945 records; 2000-2009: 502 records; 2010-2019: 532 records; 2020 onward: 274 records945through 19995022000-20095322010-20192742020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 1999945
2000-2009502
2010-2019532
2020 onward274
Share of records by publication typeReviews: 1.5 percent; Meta-analyses: 0.0 percent; Randomized controlled trials: 1.0 percentReviews1.5% (34)Meta-analyses0.0% (0)Randomized controlled trials1.0% (22)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 2,253 PubMed records
TypeRecordsShare
Reviews341.5%
Meta-analyses00.0%
Randomized controlled trials221.0%

Method: PubMed query "Cholic Acid"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in drugs and chemicals

Studies of a chemical or drug can answer very different questions: what it is and how it behaves in cells and animals, how the body handles it, and whether it changes outcomes in people. Laboratory and animal findings often do not carry over to patients, and observational studies of exposures are confounded by who uses a substance and why. Nothing on this page is a recommendation to use, avoid, start or stop any substance or medicine; talk to a qualified clinician or pharmacist about your own situation. Check the dose, the species, the comparison group and whether a patient-relevant outcome was measured.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Skin delivery of epigallocatechin-3-gallate (EGCG) and hyaluronic acid loaded nano-transfersomes for antioxidant and anti-aging effects in UV radiation induced skin damage
Avadhani KS, Manikkath J, Tiwari M, Chandrasekhar M, Godavarthi A, Vidya SM, et al.
2017Research article
Design not recorded in structured metadata
192cc by
PMID 28155509 · DOI · PMC8253143
Cholic acid therapy in Zellweger spectrum disorders
Berendse K, Klouwer FC, Koot BG, Kemper EM, Ferdinandusse S, Koelfat KV, et al.
2016Research article
Design not recorded in structured metadata
45cc by
PMID 27469511 · DOI · PMC5065608
Cholic Acid Stimulates MMP-9 in Human Colon Cancer Cells via Activation of MAPK, AP-1, and NF-κB Activity
Li S, Ung TT, Nguyen TT, Sah DK, Park SY, Jung YD
2020Research article
Design not recorded in structured metadata
43cc by
PMID 32408577 · DOI · PMC7279292
An Adaptive Cholic Acid Dimer for Selective Encapsulation
Stanciu MC, Ailiesei GL, Zaltariov MF, Cojocaru C, Gherasim C, Ciocan SM, et al.
2026Research article
Design not recorded in structured metadata
0cc by
PMID 42278295 · DOI · PMC13257168

Skin delivery of epigallocatechin-3-gallate (EGCG) and hyaluronic acid loaded nano-transfersomes for antioxidant and anti-aging effects in UV radiation induced skin damage [1]

Research article Avadhani KS, Manikkath J, Tiwari M, Chandrasekhar M, Godavarthi A, Vidya SM, et al. · · 2017 · cited 192 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
The present work attempts to develop and statistically optimize transfersomes containing EGCG and hyaluronic acid to synergize the UV radiation-protective ability of both compounds, along with imparting antioxidant and anti-aging effects.
Closing excerpt
The results underline the potential application of the developed transfersomes in sunscreen cream/lotions for improvement of UV radiation-protection along with deriving antioxidant and anti-aging effects.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (250 words)

The present work attempts to develop and statistically optimize transfersomes containing EGCG and hyaluronic acid to synergize the UV radiation-protective ability of both compounds, along with imparting antioxidant and anti-aging effects. Transfersomes were prepared by thin film hydration technique, using soy phosphatidylcholine and sodium cholate, combined with high-pressure homogenization. They were characterized with respect to size, polydispersity index, zeta potential, morphology, entrapment efficiency, Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC), X-ray Diffraction (XRD), in vitro antioxidant activity and ex vivo skin permeation studies. Cell viability, lipid peroxidation, intracellular ROS levels and expression of MMPs (2 and 9) were determined in human keratinocyte cell lines (HaCaT). The composition of the transfersomes was statistically optimized by Design of Experiments using Box-Behnken design with four factors at three levels. The optimized transfersome formulation showed vesicle size, polydispersity index and zeta potential of 101.2 ± 6.0 nm, 0.245 ± 0.069 and -44.8 ± 5.24 mV, respectively. FTIR and DSC showed no interaction between EGCG and the selected excipients. XRD results revealed no form conversion of EGCG in its transfersomal form. The optimized transfersomes were found to increase the cell viability and reduce the lipid peroxidation, intracellular ROS and expression of MMPs in HaCaT cells. The optimized transfersomal formulation of EGCG and HA exhibited considerably higher skin permeation and deposition of EGCG than that observed with plain EGCG. The results underline the potential application of the developed transfersomes in sunscreen cream/lotions for improvement of UV radiation-protection along with deriving antioxidant and anti-aging effects.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 28155509 · DOI · PMC8253143

Cholic acid therapy in Zellweger spectrum disorders [2]

Research article Berendse K, Klouwer FC, Koot BG, Kemper EM, Ferdinandusse S, Koelfat KV, et al. · · 2016 · cited 45 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
IntroductionZellweger spectrum disorders (ZSDs) are characterized by a failure in peroxisome formation, caused by autosomal recessive mutations in different PEX genes.
Closing excerpt
However, caution is needed in patients with advanced liver disease due to possible hepatotoxic effects.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (248 words)

IntroductionZellweger spectrum disorders (ZSDs) are characterized by a failure in peroxisome formation, caused by autosomal recessive mutations in different PEX genes. At least some of the progressive and irreversible clinical abnormalities in patients with a ZSD, particularly liver dysfunction, are likely caused by the accumulation of toxic bile acid intermediates. We investigated whether cholic acid supplementation can suppress bile acid synthesis, reduce accumulation of toxic bile acid intermediates and improve liver function in these patients.MethodsAn open label, pretest-posttest design study was conducted including 19 patients with a ZSD. Participants were followed longitudinally during a period of 2.5 years prior to the start of the intervention. Subsequently, all patients received oral cholic acid and were followed during 9 months of treatment. Bile acids, peroxisomal metabolites, liver function and liver stiffness were measured at baseline and 4, 12 and 36 weeks after start of cholic acid treatment.ResultsDuring cholic acid treatment, bile acid synthesis decreased in the majority of patients. Reduced levels of bile acid intermediates were found in plasma and excretion of bile acid intermediates in urine was diminished. In patients with advanced liver disease (n = 4), cholic acid treatment resulted in increased levels of plasma transaminases, bilirubin and cholic acid with only a minor reduction in bile acid intermediates.ConclusionsOral cholic acid therapy can be used in the majority of patients with a ZSD, leading to at least partial suppression of bile acid synthesis. However, caution is needed in patients with advanced liver disease due to possible hepatotoxic effects.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 27469511 · DOI · PMC5065608

Cholic Acid Stimulates MMP-9 in Human Colon Cancer Cells via Activation of MAPK, AP-1, and NF-κB Activity [3]

Research article Li S, Ung TT, Nguyen TT, Sah DK, Park SY, Jung YD · · 2020 · cited 43 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Matrix metalloproteinase-9 (MMP-9) plays a crucial role in cell invasion and cancer metastasis.
Closing excerpt
These results demonstrate that CA could induce MMP-9 expression via ROS-dependent ERK1/2, JNK-activated AP-1, and p38-MAPK-activated NF-κB signaling pathways, which in turn stimulate cell invasion in human colon cancer cells.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (173 words)

Matrix metalloproteinase-9 (MMP-9) plays a crucial role in cell invasion and cancer metastasis. In this study, we showed that cholic acid (CA), a major primary bile acid, can induce MMP-9 expression in colon cancer HT29 and SW620 cells. CA increased reactive oxygen species (ROS) production and also activated phosphorylation of ERK1/2, JNK, and p38 MAPK. Specific inhibitors and mutagenesis studies showed that ERK1/2 and JNK functioned as upstream signals in the activation of AP-1, and p38 MAPK functioned as an upstream signal in the activation of NF-κB. N-acetyl-L-cysteine (NAC, an ROS scavenger) and diphenyleneiodonium chloride (DPI, an NADPH oxidase inhibitor) inhibited CA-induced activation of ERK1/2, JNK, and p38 MAPK, indicating that ROS production by NADPH oxidase could be the furthest upstream signal in MMP-9 expression. Colon cancer cells pretreated with CA showed remarkably enhanced invasiveness. Such enhancement was partially abrogated by MMP-9-neutralizing antibodies. These results demonstrate that CA could induce MMP-9 expression via ROS-dependent ERK1/2, JNK-activated AP-1, and p38-MAPK-activated NF-κB signaling pathways, which in turn stimulate cell invasion in human colon cancer cells.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32408577 · DOI · PMC7279292

An Adaptive Cholic Acid Dimer for Selective Encapsulation [4]

Research article Stanciu MC, Ailiesei GL, Zaltariov MF, Cojocaru C, Gherasim C, Ciocan SM, et al. · · 2026

Abstract reading summary — source excerpts
Opening excerpt
A novel cleft-type cholic acid dimer was synthesized from native bile acid through a six-step reaction sequence.
Closing excerpt
Steady-state fluorescence investigations implied that the quenching of pyrene emission by the dimer in an aqueous environment was chiefly a collisional or dynamic pathway rather than the generation of a ground-state dimer-pyrene assembly.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (141 words)

A novel cleft-type cholic acid dimer was synthesized from native bile acid through a six-step reaction sequence. Structural characterization was performed using FTIR, 1D NMR (1H, 13C and DEPT135), 2D NMR (1H,1H COSY; 1H,13C HSQC; 1H,13C HMBC) and ESI-MS (+). The dimer could entrap both polar and nonpolar guests within its invertible pockets, adapting to changes in solvent polarity. Specifically, UV-Vis absorption and in silico simulations revealed a moderately stable 1:1 host-guest complex for the dimer with Cresol Red sodium salt in an organic solvent. The docked dimer-pyrene complex, investigated by molecular modeling studies, demonstrated an identical 1:1 binding ratio and moderate stability in the micromolar concentration range. Steady-state fluorescence investigations implied that the quenching of pyrene emission by the dimer in an aqueous environment was chiefly a collisional or dynamic pathway rather than the generation of a ground-state dimer-pyrene assembly.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42278295 · DOI · PMC13257168

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Bile acid analysis in human disorders of bile acid biosynthesis [5]
    Vaz FM, Ferdinandusse S · Mol Aspects Med · 2017 · cited 101 times (Europe PMC)
  • Research article Noninvasive assessment of liver function [6]
    Helmke S, Colmenero J, Everson GT · Curr Opin Gastroenterol · 2015 · cited 32 times (Europe PMC)
  • Research article The clinical and biochemical effectiveness and safety of cholic acid treatment for bile acid synthesis defects: a systematic review [7]
    Polak Y, van Dussen L, Kemper EM, Vaz FM, Klouwer FCC, Engelen M, et al. · Orphanet J Rare Dis · 2024 · cited 4 times (Europe PMC)
  • Research article Cholic acid as a treatment for cerebrotendinous xanthomatosis: a comprehensive review of safety and efficacy [8]
    Pasternack G, Courtney J, Kalsi G · Orphanet J Rare Dis · 2025 · cited 2 times (Europe PMC)
  • Research article In brief: Cholic acid (Cholbam) for bile acid synthesis disorders [9]
    · Med Lett Drugs Ther · 2016 · cited 0 times (Europe PMC)

References

  1. Avadhani KS, Manikkath J, Tiwari M, Chandrasekhar M, Godavarthi A, Vidya SM, et al.. Skin delivery of epigallocatechin-3-gallate (EGCG) and hyaluronic acid loaded nano-transfersomes for antioxidant and anti-aging effects in UV radiation induced skin damage. . 2017. PMID 28155509 · DOI · PMC8253143
  2. Berendse K, Klouwer FC, Koot BG, Kemper EM, Ferdinandusse S, Koelfat KV, et al.. Cholic acid therapy in Zellweger spectrum disorders. . 2016. PMID 27469511 · DOI · PMC5065608
  3. Li S, Ung TT, Nguyen TT, Sah DK, Park SY, Jung YD. Cholic Acid Stimulates MMP-9 in Human Colon Cancer Cells via Activation of MAPK, AP-1, and NF-κB Activity. . 2020. PMID 32408577 · DOI · PMC7279292
  4. Stanciu MC, Ailiesei GL, Zaltariov MF, Cojocaru C, Gherasim C, Ciocan SM, et al.. An Adaptive Cholic Acid Dimer for Selective Encapsulation. . 2026. PMID 42278295 · DOI · PMC13257168
  5. Vaz FM, Ferdinandusse S. Bile acid analysis in human disorders of bile acid biosynthesis. Mol Aspects Med. 2017. PMID 28322867 · DOI
  6. Helmke S, Colmenero J, Everson GT. Noninvasive assessment of liver function. Curr Opin Gastroenterol. 2015. PMID 25714706 · DOI · PMC4571483
  7. Polak Y, van Dussen L, Kemper EM, Vaz FM, Klouwer FCC, Engelen M, et al.. The clinical and biochemical effectiveness and safety of cholic acid treatment for bile acid synthesis defects: a systematic review. Orphanet J Rare Dis. 2024. PMID 39702264 · DOI · PMC11657003
  8. Pasternack G, Courtney J, Kalsi G. Cholic acid as a treatment for cerebrotendinous xanthomatosis: a comprehensive review of safety and efficacy. Orphanet J Rare Dis. 2025. PMID 40731019 · DOI · PMC12305907
  9. . In brief: Cholic acid (Cholbam) for bile acid synthesis disorders. Med Lett Drugs Ther. 2016. PMID 27101212

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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At a glance

2,253
PubMed records on this heading
12%
published since 2020
34
review articles
22
randomized trials
9
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

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