Liver, Pancreas, and Biliary TractImpaired human gallbladder lipid absorption in cholesterol gallstone disease and its effect on cholesterol solubility in bile☆
Section snippets
Materials and methods
The study protocol complied with our institute's ethical guidelines for animal and human studies, and consent was obtained from the patients.
Native gallbladder bile lipid composition in controls and cholesterol gallstone patients
The mean age (55.9 ± 11.2 vs. 58.2 ± 5.3 years [mean ± SD]) and sex distribution (men/women, 3/3 vs. ¾) were comparable in the control and cholesterol gallstone groups. For native gallbladder bile composition, the cholesterol molar percentage was significantly higher in the cholesterol gallstone group than in the control group (10.3% ± 3.3% vs. 6.6% ± 2.3%, respectively [mean ± SD]; P < 0.05). The cholesterol saturation index (CSI) was also higher in the cholesterol gallstone group than in
Discussion
The main finding of this study, performed using the isolated, intra-arterially perfused gallbladder model, was that gallbladder cholesterol absorption and phosphatidylcholine absorption from standard bile were markedly reduced in organs obtained from cholesterol gallstone patients compared with those from controls, whereas bile salt absorption was less affected. Consequently, over the experimental period of 5 hours, the control gallbladders induced a significant reduction of cholesterol and
Acknowledgements
The authors thank Giuseppe Di Lullo for technical assistance in electron microscopy, Marina Pines for revising the English text, and the veterinary surgeons of the Tor Cervara abattoir of Rome, Italy, for providing the pig gallbladders.
References (24)
- et al.
The role of the concanavalin A–binding fraction in cholesterol crystallization in native human bile
J Hepatol
(1997) - et al.
Cholesterol saturation, not proteins or cholecystitis, is critical for crystal formation in human gallbladder bile
Gastroenterology
(1998) - et al.
No pathophysiologic relationship of soluble biliar y proteins to cholesterol crystallization in human bile
J Lipid Res
(1999) - et al.
Inducing cholesterol precipitation from pig bile with β-cyclodextrin and cholesterol dietary supplementation
J Hepatol
(1997) - et al.
Excess membrane cholesterol alters human gallbladder muscle contractility and membrane fluidity
Gastroenterology
(1999) - et al.
Reduced cholesterol metastability of hepatic bile and its further decline in gallbladder bile in patients with cholesterol gallstones
Gut
(1993) - et al.
An update on the pathogenesis and treatment of cholesterol gallstones
Scand J Gastroenterol
(1997) - et al.
Human gallbladder mucosal function. Effects on intraluminal fluid and lipid composition in health and disease
Dig Dis Sci
(1998) - et al.
The human gallbladder increases cholesterol solubility in bile by differential lipid absorption: a study using a new in vitro model of isolated intraarterially perfused gallbladder
Hepatology
(1998) - et al.
Pigment gallstone disease: summary of the National Institutes of Health–International Workshop
Hepatology
(1982)
Abnormalities in gallbladder morphology and function in patients with cholelithiasis
Ann Surg
Morphometric analysis of gallbladder adenocarcinoma: discrimination between carcinoma and dysplasia
Virchows Arch A Pathol Anat
Cited by (52)
Bile Metabolism and Lithogenesis: An Update
2019, Surgical Clinics of North AmericaCitation Excerpt :The mucosal lining of the gallbladder is shielded from potential damage because of the high level of prostaglandin E2, which stimulates the secretion of mucin within the lumen, which not only acts as a barrier but also neutralizes harmful free radicals present within bile salts, which are directly cytotoxic. The mucosal barrier is composed of a single layer of epithelial cells, which allow diffusion of ions and water across the membrane, a process that plays a key role in concentrating bile and aiding in the digestion of fats.24,25 Biliary stone formation is heavily dependent on both the composition of bile and presence of mucin, making physiologic alterations in gallbladder function an important variable in the development of biliary lithiasis, which is discussed in further detail later in the article.
Pravastatin activates the expression of farnesoid X receptor and liver X receptor alpha in Hep3B cells
2014, Hepatobiliary and Pancreatic Diseases InternationalThe role of the gallbladder in humans
2013, Revista de Gastroenterologia de MexicoCitation Excerpt :Therefore, it will be absorbed with the phospholipid vesicles to a greater degree (99.9%), in accordance with the solubility of the anhydrous cholesterol. The phospholipid vesicles can be absorbed by the gallbladder mucosa in different ways.7–12,24,27–29 And so, the greater the absorption of vesicular cholesterol by the gallbladder mucosa is, the lower the concentration of the cholesterol in the phospholipid vesicles of the gallbladder bile.
Pathogenesis of cholesterol and pigment gallstones: An update
2011, Clinics and Research in Hepatology and GastroenterologyPathogenesis of gallstones
2010, Gastroenterology Clinics of North America
- ☆
Address requests for reprints to: Stefano Ginanni Corradini, M.D., Ph.D., Via Asmara 9-B, 00199 Rome, Italy. e-mail: [email protected]; fax: (39) 06-4453319.