High-Performance Liquid Chromatography of Bilirubin Conjugates in Bile: Effect of<i>β</i>-Glucuronidase on the Bile Pigments

Skar, Viggo; Saxerholt, Henri

doi:10.3109/00365528909093105

Cited by 12 publications

(7 citation statements)

References 36 publications

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“…Subsequent experiments in which E.coli was incubated with human bile showed that sediment consisting chiefly of calcium bilirubinate was produced (61). Betaglucuronidase is today the most accepted and affirmed mechanism of bacterial involvement in the gallstones pathogenesis (62)(63)(64)(65)(66)(67). In dogs, where spontaneous bacterobilia is common, brown pigment stones could be produced simply by narrowing the cystic duct with ligatures.…”

Section: Beta-glucuronidasementioning

confidence: 99%

The role of bacteria in gallstone pathogenesis

Swidsinski

Lee²

2001

Front Biosci

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Bacteria are often found in high concentrations in brown pigment and less so in cholesterol gallstones. Although it is intriguing to hypothesize that cholesterol stone formation is non-bacterial in nature and principally different from the pathogenesis of "infectious" brown pigment gallstones, it is more likely that significant overlap exists between the two processes. Most gallstones are composite in nature. Using molecular-genetic methods, bacteria can be found in most pure cholesterol gallstones (i.e. those whose structure consists of more than 90% cholesterol). The natural history of the gallstones development is unknown. It is likely that brown pigment stones can evolve in their chemical composition after the termination of the infectious process that initiate their formation, and may further develop into either mixed or nearly pure cholesterol stones. In a similar fashion, cholesterol-poor or black pigment gallstones may act as foreign bodies to enhance the propensity of bacterial colonization in the presence of pre-existing gallstones or cholangitis, thereby activating pathways of bacterial lithogenesis and resulting in the encasement of cholesterol nuclei with pigment shells and/or in the internal remodeling of extant stones. It is often difficult, if not impossible, to ascertain whether bacterial infection of bile arose before stone formation or vice-versa. The development of gallstones (nucleation, assembly of microcalculi, growth, remodeling) includes the interaction of both bacterial and non-bacterial mechanisms, working discontinuously over years and decades and shaping the structural individuality of each stone. At cholecystectomy, the gallstone removed from the patient represents the end product of a long pathologic process. Although our understanding of the exact temporal contribution of bacteria in lithogenesis is incomplete, it is important for the clinician to realize that most gallstones are colonized by a bacterial biofilm, even though the bile may be culture-negative.

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Section: Beta-glucuronidasementioning

confidence: 99%

The role of bacteria in gallstone pathogenesis

Swidsinski

Lee²

2001

Front Biosci

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“…The importance of the predominance of E. coli is seen by the fact that older studies have shown glucoronidase enzymatic activity of E. coli to have role to play in calcium billirubinate gallstone formation. [3][4][5][6][7][8][9][10][11][12][13] The infection of bile could not be established as a cause of stone formation but is associated with billary stone as shown in Table 5 and Table 6 and test for association (chi-square test) of gallstone with infection shows that we cannot exclude the possibility of them being an innocent bystander.…”

Section: Discussionmentioning

confidence: 99%

“…stone formation. [6][7][8][9][10][11][12] Amount and properties of mucin secreted by infected gall bladder can lead to a nidus formation for gall stone. [13][14][15][16] Bacteria can lead to stone formation by many other pathways e.g.…”

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confidence: 99%

Morphological spectrum of gallstone and bacteriology of bile in patient of cholelithiasis visiting tertiary care centre in North India

Gandhi¹,

Bhargava²,

Bansal³

et al. 2020

Int Surg J

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Background: Calculus biliary tract disease continues to be a major health concern. It is normal to see predisposing factors such as cirrhosis, ileal resection in the West; while infection predominates in South East Asia as a cause. We prospectively examined gall stones in this study to investigate the causes and role of bacteria in the disease of gall stone disease.Methods: This is a cross sectional study conducted in department of surgery, Sri Guru Ram Das University of Health Sciences, Sri Amritsar, India, from November 2018-August 2020. Total 50 cases were selected and operated by lap/open cholecystectomy were included in this study. During cholecystectomy bile was aspirated and was sent to laboratory for culture. Gallstone retrieved from the specimen was classified based on morphological appearance. Results: Gallstone disease found to be common in female 92% and in the age group of 4-50 years. Bile of gallstones patients is often infected. In this study though morphologically cholesterol stones were commonest but mixed stones were associated with highest infection rates. Most common bile infecting bacterium in all kinds of stones was found to be E. coli 60.8% followed by klebsiella 17.3% and proteus 17.3%. All the organisms cultured were sensitive to cephalosporins, quinolones, aminoglycosides and penicillin group of antibiotics.Conclusions: Bile culture was positive in 46% of the cases. Morphologically cholesterol stones were commonest 52% but mixed stones were associated with highest infection rates (80%). Most common bile infecting bacterium in all kinds of stones was found to be E. coli.

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“…The β-glucuronidase produced by a bacterial infection of biliary tract can decompose bilirubin-glucuronide diester, produce bilirubin, and bind with ionic calcium, which leads to the deposition of calcium bilirubin, and then to the formation of biliary mud and bile duct stones [9,10,11] . A small amount of fibronectin, collagen, fibrin, and immunoglobulin A in bile accelerates the biliary mud covering the stent surface.…”

Section: Discussionmentioning

confidence: 99%

Investigation of a New Superhydrophobic, Oleophobic-Coated Biliary Duct Stent and its Preventive Effect on Biliary Mud in Vitro

Zhang

Qian

et al. 2019

Preprint

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Background and AimA new type of superhydrophobic, oleophobic-coated biliary stent was created, and its characteristics and preventive effect on biliary mud deposition in vitro are studied herein. MethodsThe observational experiment included a bare stent group and coated stent group, with 10 stents per group. The groups were used in a model of the extracorporeal biliary perfusion system with bacterial infection, and the experiment was terminated when the stent was completely blocked. Changes of bile characteristics before and after the experiment, patency time, and amount of bile sludge deposition were compared between the groups. The t-test and analysis of variance were used to analyze the data. ResultsIn the bare stent group, contact angles of bile were about 80.4 degrees and 79.8 degrees before and after the experiment, respectively. There was no change in the effect of bile aversion after the experiment between the groups (P < 0.05). In the coated stent group, contact angles of bile changed from 143.3 degrees before the experiment to 135.7 degrees after the experiment; the effect of the coating decreased significantly after the experiment (P > 0.05). The patency times were 8 weeks and 23 weeks in the bare and coated stent groups, respectively (P > 0.05). Depositions of biliary mud were 47 mg and 13 mg in the bare and coated stent groups, respectively (P > 0.05). ConclusionThe superhydrophobic, oleophobic-coated biliary stent can repel bile better and play a role in preventing bile sludge deposition in the extracorporeal biliary perfusion system.

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High-Performance Liquid Chromatography of Bilirubin Conjugates in Bile: Effect ofβ-Glucuronidase on the Bile Pigments

Cited by 12 publications

References 36 publications

The role of bacteria in gallstone pathogenesis

The role of bacteria in gallstone pathogenesis

Morphological spectrum of gallstone and bacteriology of bile in patient of cholelithiasis visiting tertiary care centre in North India

Investigation of a New Superhydrophobic, Oleophobic-Coated Biliary Duct Stent and its Preventive Effect on Biliary Mud in Vitro

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