Skip to main content
. Author manuscript; available in PMC: 2013 Feb 22.
Published in final edited form as: Gastroenterology. 2012 Feb 24;142(7):1581–91.e6. doi: 10.1053/j.gastro.2012.02.033

Figure 6.

Figure 6

Proposed model of BA recycling in CF. As compared with (A) normal conditions, (B) the duodenum in CF is abnormally acidic and overproduces the relaxing factor VIP, which is also locally produced, together with FGF15, by the gallbladder. Gallbladder emptying is impaired, impeding BA influx into the intestine. BA transporters (closed circles) are down-regulated in the ileum and increased in the gallbladder, providing a cholecystohepatic shunt for BAs. This pathway maintains the level of BA transport back to the liver, and results in a lower proportion of secondary BAs.