TUDCA (tauroursodeoxycholic acid)
Information on nutritional supplements people with ALS have been taking
ALSUntangled evaluation report
Effects on ALS
TUDCA is a taurine-conjugated form of ursodiol and is commonly used for treatment of chronic cholestatic liver diseases and for gallstone. It possesses many additional ancillary features, including the inhibition of mitochondrial-associated apoptosis through different mechanisms. It has been shown that, in a cellular model of superoxide dismutase 1 neurodegeneration, glycine-conjugated UDCA inhibits nitrite production and prevents matrix metallopeptidase 9 activation [1].
At the end of the 54-week treatment period, patients in the TUDCA group had a mean ALSFRS-R score corresponding to that of the placebo group at week 36. This suggests that a 1-year TUDCA treatment may slow ALS deterioration by 18 weeks and leads us to suppose that a longer duration of treatment may produce an even more accentuated between-group divergence [1].
References
[1] <bibtex> @article{Elia2015, abstract = {BACKGROUND AND PURPOSE: Tauroursodeoxycholic acid (TUDCA) is a hydrophilic bile acid that is produced in the liver and used for treatment of chronic cholestatic liver diseases. Experimental studies suggest that TUDCA may have cytoprotective and anti-apoptotic action, with potential neuroprotective activity. A proof of principle approach was adopted to provide preliminary data regarding the efficacy and tolerability of TUDCA in a series of patients with amyotrophic lateral sclerosis (ALS).
METHODS: As a proof of principle, using a double-blind placebo controlled design, 34 ALS patients under treatment with riluzole who were randomized to placebo or TUDCA (1 g twice daily for 54 weeks) were evaluated after a lead-in period of 3 months. The patients were examined every 6 weeks. The primary outcome was the proportion of responders [those subjects with improvement of at least 15\% in the Amyotrophic Lateral Sclerosis Functional Rating Scale Revised (ALSFRS-R) slope during the treatment period compared to the lead-in phase]. Secondary outcomes included between-treatment comparison of ALSFRS-R at study end, comparison of the linear regression slopes for ALSFFRS-R mean scores and the occurrence of adverse events.
RESULTS: Tauroursodeoxycholic acid was well tolerated; there were no between-group differences for adverse events. The proportion of responders was higher under TUDCA (87\%) than under placebo (P = 0.021; 43\%). At study end baseline-adjusted ALSFRS-R was significantly higher (P = 0.007) in TUDCA than in placebo groups. Comparison of the slopes of regression analysis showed slower progression in the TUDCA than in the placebo group (P < 0.01).
CONCLUSIONS: This pilot study provides preliminary clinical data indicating that TUDCA is safe and may be effective in ALS.}, author = {Elia, A E and Lalli, S and Monsurr\`{o}, M R and Sagnelli, A and Taiello, A C and Reggiori, B and {La Bella}, V and Tedeschi, G and Albanese, A}, doi = {10.1111/ene.12664}, issn = {1468-1331}, journal = {European journal of neurology : the official journal of the European Federation of Neurological Societies}, mendeley-groups = {taurine}, month = feb, pmid = {25664595}, title = Template:Tauroursodeoxycholic acid in the treatment of patients with amyotrophic lateral sclerosis., url = {http://www.ncbi.nlm.nih.gov/pubmed/25664595}, year = {2015} } </bibtex>
