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Bile acid composition in brown pigment stones
1Kyushu University Faculty of Medicine, Department of Surgery I, Fukuoka, Japan.
Digestive Diseases and Sciences
|January 1, 1990
Summary
Bacterial infection significantly increases free bile acids, contributing to brown pigment gallstone formation. Lower total bile acid levels in patients with gallstones suggest infection plays a key role.
Area of Science:
- Gastroenterology
- Biochemistry
- Microbiology
Background:
- Brown pigment gallstones are a common biliary pathology.
- The role of bile acid composition and bacterial infection in their formation is not fully understood.
Purpose of the Study:
- To investigate the role of bacterial infection and bile acid profiles in the pathogenesis of brown pigment gallstones.
Main Methods:
- Fractionation of bile acids (free, glycine/taurine conjugates, sulfates) using DEAP-LH-20 chromatography.
- Quantification of bile acids via gas chromatography.
- Analysis of 28 brown pigment gallstone cases, categorized by the presence or absence of bile acid-deconjugating bacteria.
Main Results:
- Cases with bile acid-deconjugating bacteria showed significantly higher free bile acid levels (62% +/- 34%) compared to those without (0.1%).
- Free bile acids were consistently elevated in gallstones versus corresponding bile.
- Total bile acid concentration was markedly lower in patients with brown pigment gallstones (13 mg/ml) compared to controls (50 mg/ml).
- Biliary infection was prevalent in most brown pigment gallstone cases.
Conclusions:
- Bacterial infection is strongly implicated in both the initiation and growth of brown pigment gallstones.
- Elevated free bile acids, likely due to bacterial deconjugation, are a key factor in brown pigment gallstone formation.
- Reduced total bile acid concentration may predispose individuals to gallstone development in the presence of infection.