In vitro dissolution of cholesterol gallstones

Area of Science:

• Biochemistry
• Organic Chemistry
• Pharmacology

Background:

• Methyl tert-butyl ether (MTBE) is the standard solvent for in vivo cholesterol gallstone dissolution.
• MTBE has limitations including high volatility, flammability, and potential toxicity.
• Current MTBE-based therapies can be lengthy, taking several hours.

Purpose of the Study:

• To identify alternative solvents for cholesterol gallstone dissolution.
• To find solvents superior to MTBE in terms of safety and/or speed.
• To evaluate the efficacy of novel solvent mixtures for gallstone treatment.

Main Methods:

• Comparative analysis of MTBE with several other solvents for cholesterol-dissolving capacity.
• Human cholesterol gallstones were exposed to solvent:ethanol mixtures without agitation.
• Solvent mixtures included MTBE:ethanol and alternative solvent:ethanol formulations.

Main Results:

• Six alternative solvents demonstrated higher cholesterol-dissolving capacities than MTBE.
• Certain solvent mixtures dissolved gallstones up to twice as fast as MTBE:ethanol.
• Faster solvents included cyclic ethers (THF, MTHF, THP, MTHP, DMTHF) and limonene.
• Some alternatives exhibited lower volatility and higher flash points than MTBE, enhancing safety.
• Tetrahydrofuran (THF) and pyridine caused precipitation of bile components.

Conclusions:

• Several novel solvents show potential for superior in vivo cholesterol gallstone dissolution compared to MTBE.
• Cyclic ethers and limonene represent promising alternatives for faster and safer gallstone treatment.
• Further research is warranted to explore the therapeutic potential of these alternative solvents.