Biliary bile acids in cholelithiasis and carcinoma of the gall bladder

Shukla, Vijay K.; Tiwari, Suman; Roy, Samarjit

doi:10.1097/00008469-199303000-00008

Cited by 56 publications

(35 citation statements)

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“…: bacterial glucoronidase yielding some high energy intermediates after acting on bile which are potential mutagens [22]; bacterial products acting upon primary bile acids and producing high concentration carcinogenic secondary bile acids [23]; production of nitroso compounds from nitrates by the action of bacterial enzymes [24]; and chronic bacterial infection leading to obstruction and producing persistent chemical and mechanical injuries [25]. Therefore, on the basis of such high magnitude of typhoid carrier state in patients with gall bladder diseases, it may be proposed that this chronic infection may be one of the very important etiological factors in the genesis of gall bladder malignancy.…”

Section: Discussionmentioning

confidence: 99%

Association of carcinoma of the gallbladder with typhoid carriage in a typhoid endemic area using nested PCR

Nath

Singh

Kumar

et al. 2008

J Infect Dev Ctries

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Background: Although well studied the association between chronic typhoid carrier state and carcinoma of the gallbladder (CaGB) remains unproven. Methodology: The study was performed at a tertiary care medical center in North India and involved 52 patients with CaGB, 223 patients with benign gallbladder diseases, 508 healthy individuals and, 424 corpses. For the detection of Salmonella enterica serovar Typhi, hepatobiliary specimens were subjected to DNA extraction for specific nested-PCR amplification of the S. Typhi flagellin gene. Anti-Vi S. Typhi antibodies were detected in serum samples from patients by indirect haemagglutination. Results: Thirty five of the 52 (67.3%) CaGB patients were PCR-positive for the S. Typhi flagellin gene; significantly higher than for patients with benign gallbladder diseases (95/223, 42.6%; p<0.01) and corpses (35/424, 8.2%; p<0.001). The numbers of individuals that had significant anti-Vi antibody titres (≥160) in their serum were 20/52 (38.5%) for CaGB patients, 31/223 (13.9%) for patients with benign gallbladder diseases, and 47/508 (9.2%) for healthy individuals. Conclusions: Specific nested-PCR amplification of the S. Typhi flagellin gene in hepato-biliary specimens was more sensitive for detection of S. Typhi carriage than anti-Vi antibody titres in serum. The results demonstrate an association between typhoid carriage and gallbladder diseases, both CaGB and benign. S. Typhi specific immunosuppression is also suggested in patients with gallbladder diseases.

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Section: Discussionmentioning

confidence: 99%

Association of carcinoma of the gallbladder with typhoid carriage in a typhoid endemic area using nested PCR

Nath

Singh

Kumar

et al. 2008

J Infect Dev Ctries

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“…One study showed that patients with gallbladder cancer had a significantly higher concentration of secondary bile acids than control patients. 44) A hypothesis described in another report was that lipophilic bile acids (lithocholate and deoxycholate) are excreted in bile, and if retained over a long enough period in the gallbladder, may be carcinogenic. 45) Furthermore, it has been reported that secondary bile acids may be a causal factor in the development of colon cancer, 46) and that there was a positive association between constipation and an increased risk for colon cancer.…”

Section: Discussionmentioning

confidence: 99%

Bowel movement frequency, medical history and the risk of gallbladder cancer death: A cohort study in Japan

et al. 2004

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Few risk factors for gallbladder cancer have been identified with sufficient statistical power, because this cancer is rare. The present study was conducted to evaluate the association of bowel movement frequency and medical history with the risk of death from gallbladder cancer using the data set from a largescale cohort study. A total of 113,394 participants (42.0% males), aged 40 to 89 years, were followed up for 11 years. Information on the medical history of selected diseases, history of blood transfusions, frequency of stools, and tendency toward diarrhea at baseline was collected through a self-administered questionnaire. The Cox proportional hazard model was used to estimate the hazard ratio (HR). During the follow-up period, a total of 116 deaths (46 males, 70 females) from gallbladder cancer were identified. After adjustments for age and gender, history of hepatic disease (HR: 2.28; 95% confidence intervals (95% CI): 1.24-4.21), frequency of stool, and tendency toward diarrhea (HR: 0.26; 95% CI: 0.08-0.83) were found to be significantly associated with the risk of death from gallbladder cancer. Compared with those who had a stool at least once a day, the HR was 2.06 (95% CI: 0.82-5.18) for those who had a stool less than once in 6 days (P for trend = = = =0.050). In this prospective study, constipation and a history of hepatic disease were found to elevate the risk of gallbladder cancer death, whereas a tendency toward diarrhea diminished it. allbladder cancer has a poor prognosis, and its incidence increases with age.1-3) Moreover, there are geographic and gender variations in both prevalence and mortality. [4][5][6] The mortality rate is relatively high in Japan, [7][8][9][10] and the incidence is increasing.11-13) Although several risk factors for gallbladder cancer have been suggested, such as obesity, 14) history of gallstones 1,15,16,[23][24][25][26][27][28][29] or cholecystitis, 20,[22][23][24][25][26][27][28][29][30] history of typhoid infection, 14,15,21,[31][32][33][34] and life style-related factors, 17-23) the etiology of gallbladder cancer is poorly understood. However, because of the rarity of gallbladder cancer, most previous research has involved a case-control study of small numbers of patients. Therefore, they lacked sufficient statistical power to identify risk factors for this cancer. The results have been inconsistent regarding the association between bowel movement frequency and the risk of gallbladder cancer. A case-control study 20) indicated that loose stools were associated with an increased risk of gallbladder cancer, while constipation was found to be related to risk of gallbladder cancer in another case-control study. 35)Using the data set from a large-scale prospective cohort study with approximately 11 years of follow-up, we assessed the association of the medical history of selected diseases and condition of bowel movement frequency with the risk of death from gallbladder cancer. Subjects and MethodsJACC study (study cohorts). The Japan Collaborative Cohort Study for Eva...

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“…Various risk factors like cholelithiasis [2], external carcinogens [3,4], free radicals, secondary bile acids [5], lipid peroxidation products [6], and heavy metals [7] have been proposed in its pathogenesis but none has stood the test of time. Micronutrients and antioxidants have assumed an important protective role in carcinogenesis.…”

Section: Introductionmentioning

confidence: 99%