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Effect of deoxycholate on immunoglobulin G concentration in bile: Studies in humans and pigs

Authors

  • Juan R. Sanabria,

    1. Departments of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Canada
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  • Aravinda Upadhya,

    1. Section of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Canada
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  • Brendan Mullen,

    1. Departments of Pathology, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Canada
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  • P. Robert C. Harvey,

    1. Section of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Canada
    2. Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, MO
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  • Steven M. Strasberg MD

    Corresponding author
    1. Section of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Canada
    • Washington University School of Medicine, Box 8109, 4940 Parkview Place CSRB 3360, St. Louis, MO 63110
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Abstract

Because an increase in biliary deoxycholate levels seems to be a risk factor for cholesterol gallstone formation, we determined the relationship between deoxycholate levels and levels of the pronucleating protein, immunoglobulin G (Ig) in human gallbladder bile. Patients with cholesterol gallstones had a higher concentration of biliary IgG compared with a pigmented stone group and control patients. This was associated with the simultaneous presence of two conditions in the cholesterol stone group, supersaturated bile and a high deoxycholate/cholate ratio. The other patient groups met only one of the two conditions. Next, animal studies were performed to determine if model biles mimicking the two conditions could affect IgG secretion by the gallbladder. Gallbladders were exposed in vivo and then in an Ussing chamber to model biles. The voltage clamp technique was used to monitor functional integrity of the preparation. Three different model biles were tested: (1) taurodeoxycholate (TDC), 80%; taurocholate (TC), 20%; and cholesterol saturation index (CSI), 1.2; (2) TDC, 20%; TC, 80%; and CSI, 1.2; and (3) TDC, 80%; TC, 20%; and CSI, 0.6. IgG concentrations became significantly higher in group 1 than in the other two groups. The concentration of mucous glycoprotein was also significantly greater in group 1 when compared with group 2. Plasma cells were increased in number in mucosal and submucosal layers in group 1. We conclude that cholesterol supersaturated model bile with high content of TDC induces gallbladder epithelial alterations, which increase the luminal concentration of IgG and mucous glycoprotein. (Hepatology 1995;21:215–222).

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