Canine bile contains anticrystallization factors that inhibit precipitation of calcium carbonate

Authors

  • Lillian G. Dawes M.D.,

    Corresponding author
    1. Department of Surgery, Northwestern University Medical School and Veteran's Administration Lakeside Medical Center, Chicago, Illinois 60611
    • Department of Surgery, 201 Wesley Pavilion, 250 East Superior Street, Chicago, IL 60611
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  • Robert V. Rege,

    1. Department of Surgery, Northwestern University Medical School and Veteran's Administration Lakeside Medical Center, Chicago, Illinois 60611
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  • Edward W. Moore,

    1. Departments of Medicine and Physiology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia 23298
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  • Shuji Shimizu,

    1. Department of Medicine, Northwestern University Medical School and Veteran's Administration Lakeside Medical Center, Chicago, Illinois 60611
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  • J. Donald Ostrow

    1. Department of Medicine, Northwestern University Medical School and Veteran's Administration Lakeside Medical Center, Chicago, Illinois 60611
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Abstract

Previous studies have strongly suggested that human bile contains a substance(s) that interferes with the precipitation of calcium phosphate and carbonate from solution. These studies, however, did not distinguish between calcium binding by biliary constituents resulting in decreased calcium carbonate saturation (alterations in solution thermodynamics) and true inhibition of calcium salt precipitation by kinetic factors. Because our recent studies have shown that canine common duct bile is always supersaturated with calcium carbonate (thermodynamically at risk for precipitation), we hypothesized that it must contain kinetic factors that inhibit formation and/or growth of calcium carbonate crystals. Effects of canine bile, bovine albumin and the bile salt taurocholate on calcium carbonate precipitation were studied in highly supersaturated solutions of calcium carbonate that spontaneously undergo rapid precipitation. Measured free ionized calcium concentrations, [Ca++], and calculated calcium carbonate saturation indices were compared in test solutions and controls to evaluate the thermodynamic effects of test solutions on the degree of saturation in the assay system. It is shown that addition of only 0.2 ml of normal canine gallbladder bile to the assay system (a 1:101 dilution of biliary components) abolished precipitation. A lesser inhibitory effect (a decrease in the rate of precipitation) was observed when gallbladder bile was diluted but was lost after 10-fold dilution. Canine common duct bile caused a decrease in the rate of precipitation similar to diluted gallbladder bile. In contrast, sodium taurocholate (250 mmol/L), the major bile salt in the dog, and albumin (1.5 gm/L), the most abundant protein in bile, had only a minimal inhibitory effect. We conclude that normal bile contains kinetic factors that inhibit calcium carbonate precipitation and protect against calcium-containing gallstones. These effects are not due to changes in calcium carbonate saturation but rather to alterations in precipitation kinetics. (HEPATOLOGY 1991;14:701–706.)

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