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Sequential changes in biliary lipids and gallbladder ion transport during gallstone formation

D I Giurgiu1, K D Saunders-Kirkwood, J J Roslyn

  • 1Philadelphia VAMC, Pennsylvania, USA.

Annals of Surgery
|April 1, 1997
PubMed
Summary

Gallstone formation involves sequential changes in gallbladder ion transport, with early stages showing increased sodium absorption and later stages exhibiting altered fluxes linked to increased biliary lipids and calcium.

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Area of Science:

  • Gastroenterology
  • Biliary Physiology
  • Molecular Biology

Background:

  • Gallstone (GS) formation is linked to altered gallbladder (GB) ion transport and increased biliary lipids and calcium (Ca2+).
  • The precise longitudinal relationship between ion transport and biliary lipid changes during GS development remains undefined.

Purpose of the Study:

  • To correlate gallbladder (GB) sodium (Na+) and chloride (Cl-) fluxes with biliary lipid composition throughout gallstone (GS) formation.
  • To define the sequential changes in GB ion transport during the development of gallstones.

Main Methods:

  • Prairie dogs were fed standard or cholesterol-enriched diets for 4 to 21 days.
  • Bile was analyzed for lipids and Ca2+; animals were staged as Pre-Crystal, Crystal, or GS.
  • Gallbladders were mounted in Ussing chambers to measure electrophysiologic parameters and unidirectional Na+ and Cl- fluxes.

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Main Results:

  • Short-circuit current and potential difference decreased significantly in the GS stage.
  • Net Na+ absorption increased in the Pre-Crystal stage but decreased in the GS stage.
  • Increased serosa-to-mucosa flux of Na+ and Cl- characterized the Crystal stage; biliary lipids and Ca2+ correlated positively with ion fluxes.

Conclusions:

  • Gallbladder epithelial ion transport changes sequentially during gallstone formation.
  • The Pre-Crystal stage shows increased Na+ absorption, while the Crystal stage exhibits prosecretory stimuli on Na+ and Cl- fluxes.
  • Elevated GB bile Ca2+ and total bile acids may drive these ion transport changes in later stages.