Experimentelle Gallensteinbildung. �tiologische Bedeutung von?-Glucuronidase-bildenden Bakterien und Gallenwegsobstruktionen

Abstract

Bile pigment gallstones were produced in six of six mongrel dogs by narrowing the cystic duct with ligature after a postoperative interval of seven days. beta-Glucuronidase producing group G Streptococcus and Staphylococcus aureus were found in the bile, the gallbladder wall, and the liver. In another trial similar gallstones were produced in four of eight dogs after mere injection of beta-glucuronidase producing Escherichia coli into the spleen resp. in six of eight dogs after injection of E. coli into the colon without ligature of the cystic duct. In an additional series gallstones were produced in six dogs after injection of beta-glucuronidase producing E. coli into the colon plus ligature of the cystic duct. The injected strain of E. coli was found in the bile, the gallbladder wall, the liver, and even within the produced gallstones. In a control group in none of six dogs gallstones were present. beta-Glucuronidase producing group G Streptococcus was found in the gallbladder of one dog, Pseudomonas aeruginosa was found in the gallbladder of another dog and Staphylococcus aureus in the liver and gallbladder wall of a third dog. We conclude from our experiments that merely bacterial infection of the biliary tract can lead to gallstone formation. The bacterial colonization of the liver and the biliary tract is promoted by biliary tract obstruction. beta-Glucuronidase producing bacteria increase the amount of beta-glucuronidase in the bile thus leading to calcium bilirubinate precipitation and gallstone formation by deconjugation of bilirubindiglucuronide.

Role of osteopontin in diet-induced brown gallstone formation in rats

“…Another study indicated that the model could be established in mongrel dogs via injection of b-glucuronidase-producing Escherichia coli into the spleen, or by narrowing the bile duct with ligature after a 7-day post-operative interval. [21] Furthermore, hypodermic injection of lincomycin also reportedly induces pigment gallstone formation in guinea pigs. [22] In our study, we established a brown pigment stone rat model which we induced through a modified LD, with protein content (12%) far lower than in the CD (21%).…”

“…A previous study by Suzuki et al [20] reported that a pigment gallstone rat model could be established through a low protein diet, resulting in incomplete obstruction of the terminal common bile duct. Another study indicated that the model could be established in mongrel dogs via injection of β-glucuronidase-producing Escherichia coli into the spleen, or by narrowing the bile duct with ligature after a 7-day post-operative interval [21] . Furthermore, hypodermic injection of lincomycin also reportedly induces pigment gallstone formation in guinea pigs [22] .…”

Bakterien in Gallenblasenwand und Gallensteinen ?Indikation zur Cholecystektomie

“…Die Anziichtung und Identifizierung der Bakterien erfolgte nach den friiher angegebenen Methoden [8]. Nach Cholecystektomie wurden die Gallenflfissigkeit, die Gallenblasenwand und die Gallensteine mit mikrobiologischen Methoden auf ihren Gehalt an Bakterien untersucht.…”

“…Die vorliegenden Ergebnisse bestfitigen frfihere klinische und experimentelle Untersuchungen, nach denen bei Gallensteintrfigern nicht nur die Gallenflfissigkeit, sondern auch die Gallenblasenwand und die Gallensteine bakteriell besiedelt sein k6nnen [1,4,8,12]. Ob die Bakterien in der Gallenblasenwand sogar hfiufiger sind als in der Galle, muB often blciben, da ein statistisch signifikanter Unterschied nicht vorhanden war.…”

“…Auger in der Galle k6nnen Bakterien aber auch in der Gallenblasenwand und im Gallenstein vorkommen [1,4,8,12]. Auger in der Galle k6nnen Bakterien aber auch in der Gallenblasenwand und im Gallenstein vorkommen [1,4,8,12].…”