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ursodeoxycholic acid udca ursodiol bile metabolite metabolism biosynthesis mechanism pathway biosynthetic intermediate biogenesis substrate precursor synthesis derivative bioprecursor metabolic endogenous contractor human metabolome database hmdb liver ducts generic medication gallstone disease cholelithiasis biliary sludge cholesterol bile cholesterol-rich gallstones dyskinesia cholangitis primary pbc cirrhosis sclerosing intrahepatic cholestasis pregnancy cholestasis reflux gastritis cystic fibrosis non-alcoholic fatty liver atresia graft-versus-host disease choleretic immunomodulating anti-inflammatory 3d