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Pathways of cholesterol crystallization in model bile and native bile
P Portincasa1, A Moschetta, K J van Erpecum
1Department of Internal Medicine and Public Medicine (DIMIMP) University Medical School, 70124 Bari, Italy. p.portincasa@semeiotica.uniba.it
Summary
Cholesterol gallstone formation begins with excess cholesterol in bile, leading to crystal precipitation. This study reviews physical-chemical factors influencing cholesterol crystallization in model and human bile.
Area of Science:
- Hepatology and Gastroenterology
- Biophysics and Physical Chemistry
Background:
- Cholesterol gallstone formation is initiated by hepatic cholesterol hypersecretion and bile supersaturation.
- Cholesterol-enriched vesicles contribute to rapid cholesterol crystal precipitation in the gallbladder.
Purpose of the Study:
- To review recent concepts on cholesterol crystallization pathways.
- To investigate physical-chemical factors influencing cholesterol precipitation in model and human bile.
Main Methods:
- Utilizing artificial model biles and ex vivo human bile for investigation.
- Employing biochemical analysis, polarizing quantitative light microscopy, and turbidimetric methods.
Main Results:
- Cholesterol crystallization is modulated by factors like lipid concentration, bile salts, phospholipids, humidity, and mucins.
- Cholesterol precipitates in various forms (monohydrate, anhydrous) and habits (plate-like, needle-like, spirals).
Conclusions:
- Understanding cholesterol crystallization is key to gallstone formation.
- Model biles and human bile analysis provide insights into precipitation mechanisms.