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Bile glycoprotein mucin in sludge occluding biliary stent
Hongjun Zhang1, Tat-Kin Tsang, Christy A Jack
1Division of Gastroenterology, Department of Medicine, ENH Research Institute, Northwestern University Medical School, Evanston, IL 60201, USA.
The Journal of Laboratory and Clinical Medicine
|July 25, 2003
Summary
Bile glycoprotein mucin contributes to biliary stent occlusion by promoting bacterial adherence and sludge accumulation. This finding helps understand and potentially prevent stent blockage in patients undergoing endoscopic biliary stenting.
Area of Science:
- Gastroenterology
- Biochemistry
- Microbiology
Background:
- Endoscopic biliary stenting is a common palliative treatment for obstructive jaundice.
- Biliary stents frequently become nonfunctional due to occlusion.
- The exact composition and role of stent sludge in occlusion are not fully understood.
Purpose of the Study:
- To confirm bile glycoprotein mucin as a factor in biliary stent occlusion.
- To investigate the role of bile glycoprotein mucin in biliary-stent blockage.
- To elucidate the relationship between mucin, bacteria, and sludge formation.
Main Methods:
- Isolation of high-molecular-weight glycoprotein fraction from stent sludge using gel filtration and density gradient.
- Analysis of amino-acid and carbohydrate composition.
- Immunoblotting with monoclonal antibody against human gallbladder mucin.
- Immunofluorescence and DAPI staining to visualize mucin distribution and bacterial presence.
Main Results:
- High-molecular-weight glycoprotein extracts from 11 patients' stent sludge showed positive immunoreactivity to anti-mucin antibody.
- Immunofluorescence revealed bile glycoprotein mucin on pigmented deposits, bacterial clumps' periphery, and stent inner walls.
- Mucin was observed dispersed among bacteria in nonpigmented sludge.
Conclusions:
- Bile glycoprotein mucin is a constituent of biliary stent sludge.
- Mucin may contribute to stent occlusion by influencing bacterial adherence.
- Mucin may act as a 'cement' promoting sludge accumulation, alongside calcium bilirubinate and bacteria.