Relevance. Ursodeoxycholic acid (UDCA) is a natural hydrophilic bile acid, which initially found its use in the treatment of a number of liver diseases as a first–line therapy. UDCA reduces the secretion of cholesterol into bile and is actively used in the treatment and prevention of gallstone disease; UDCA also has the ability to stimulate hepatobiliary secretion, which is important for patients with primary biliary cholangitis and primary sclerosing cholangitis. More recent studies have shown the pleiotropy of the effects of UDCA, in terms of effects on pathophysiological processes in the liver and the entire hepatobiliary complex, for example, anti-inflammatory and antifibrotic effects, immunomodulatory and anticarcinogenic effects. Even more interesting and important were the complex mechanisms of the effect of UDCA on the development and progression of non-alcoholic fatty liver disease (NAFLD) and, further, on the pathogenetic relationships of NAFLD and cardio-vascular pathology. The article examines the possibilities of using UDCA in diseases of the gastrointestinal tract and, more broadly, the possibilities of the drug in influencing NAFLD and the development and progression of cardiovascular and metabolic diseases.
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