Objective: This study aims to explore the combined effect of rifampicin and ursodeoxycholic acid on cholestasis hepatitis treatment in rats and its impact on bile acid metabolism, with a view to understanding potential implications for liver health and athletic performance in patients.

Methods: We induced an intrahepatic cholestasis model in Sprague-Dawley rats using alpha-naphthalene isothiocyanate (ANIT, 60 mg/kg). The rats were then treated with rifampicin, ursodeoxycholic acid, or a combination of both. The study involved analyzing serum concentrations of six bile acid compounds (CA, GDCA, GCA, GCDCA, THCA, and GLCA) using LC-MS/MS technology. We also measured serum levels of AST, ALT, γ-GGT, and TBIL and conducted histopathological examinations of liver tissues using HE staining.

Results: Biochemical analysis revealed significantly elevated levels of AST, ALT, γ-GGT, and TBIL in the model rats. LC-MS/MS analysis indicated increased serum concentrations of the six bile acids in the cholestasis model. Treatment with a combination of ursodeoxycholic acid and rifampicin significantly reduced serum levels of transaminases and bile acids, and ameliorated cellular swelling and inflammatory infiltration in liver tissues.

Conclusion: The combination of rifampicin and ursodeoxycholic acid shows promise in treating intrahepatic cholestasis, outperforming treatment with ursodeoxycholic acid alone. These findings suggest potential therapeutic applications for managing liver health in athletes, given the critical role of bile acid metabolism in overall physical performance and recovery