The Anatomy of Gallstones

Womack, Nathan A.; Zeppa, Robert; Irvin, George L.

doi:10.1097/00000658-196305000-00002

Cited by 127 publications

(35 citation statements)

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“…Transition from gastric to intestinal metaplasia is a likely possibility [17]. Pre-neoplastic role of intestinal metaplasia in the gallbladder and the metaplasia → dysplasia → neoplasia sequence have received wide attention among workers [11,17,28]. The mucin profile changes with progressive transformation to neoplasia, from normal with sulfomucin predominating through metaplastic and dysplastic showing increasing amounts of sialomucin, to full-fledged neoplastic with sialomucins predominating.…”

Section: Discussionmentioning

confidence: 99%

“…Fibrosis also was more in cases with pigment calculi in our study. Mucins have been shown to be a structural component of gallstones [11,30]. Histochemical studies carried out on calculi have demonstrated presence of sulfomucins in them, especially in pigment stones [12].…”

Section: Discussionmentioning

confidence: 99%

“…Hypersecretion of mucus occurs during gallstone formation in humans [6][7][8][9] and experimental animals [10]. Apart from forming the nucleus for calculus, the mucins form a structural component of gallstones as shown by histochemical studies on calculi [11,12]. Calcium and prostaglandins can stimulate mucus secretion by gallbladder mucosa [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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A histopathological and histochemical study of cholecystitis

Anupama¹,

V.²,

Ramakrishnan³

et al. 2014

Int J Hepatobiliary Pancreat Dis

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histochemistry, composition of calculi and metaplasia, fibrosis and mucin histochemistry, fibrosis and stone composition indicated a decrease in intraepithelial total acid mucin content in chronic calculous cholecystitis. cases with severe inflammation showed the maximum decrease in sulfomucin, concomitant increase in sialomucin scores and a high incidence of gastric metaplasia. Intestinal metaplasia on other hand did not correlate with the degree of inflammation or sialomucin content. conclusion: this study concludes that normally gallbladder epithelium contains sulfated acid mucins with traces of neutral and sialomucins. the sulfomucin content decreases in chronic calculous cholecystitis and with severe inflammation, total acid mucin content decreases, neutral mucin increases, and there is a higher incidence of gastric metaplasia and pigment stones and correlating with pigment stones. this tends to have an association with severe inflammation, higher degree of fibrosis, gastric metaplasia and presence of sialomucin. Keywords: chronic calculous cholecystitis, Gallbladder stones, Metaplasia, Mucin histochemistryHow to cite this article Anupama P, Menon Nirmala V, Janaky R, Mohammed IL, Alingal MB, Sideeque NA. A histopathological and histochemical study of cholecystitis. Int J Hepatobiliary Pancreat Dis 2014;4:70-80.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A histopathological and histochemical study of cholecystitis

Anupama¹,

V.²,

Ramakrishnan³

et al. 2014

Int J Hepatobiliary Pancreat Dis

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“…In the present study, EPA was found to have a dominant anti-lithogenic effect in C57BL/6J mice. Previous animal studies (24)(25)(26) …”

Section: Discussionmentioning

confidence: 99%

“…Gallstone formation is primarily caused by the hypersaturation of cholesterol in the bile and the hypersecretion of mucin in the gallbladder (26). MUC gene expression is a well-established indicator of gallstone nucleation.…”

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confidence: 99%

Effect of eicosapentaenoic acid on cholesterol gallstone formation in C57BL/6J mice

Cho

Park

Kim

et al. 2014

Molecular Medicine Reports

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Abstract. The present study investigated the preventive effect of ω-3 fatty acids against cholesterol gallstone (CG) formation. CG formation was induced in C57BL/6J mice using a lithogenic diet (LD). The mice were divided into four treatment groups: i) LD, ii) LD plus eicosapentaenoic acid (EPA), iii) LD plus docosahexaenoic acid (DHA) and iv) LD plus EPA plus DHA. Subsequent to feeding the mice the LD for four weeks, EPA and/or DHA (70 mg/kg/day) were orally administered for eight weeks. The mice in the EPA treatment groups exhibited significantly less gallstone formation than those in the LD group. By contrast, DHA treatment only slightly suppressed gallstone formation. The expression of mucin 2, 5AC, 5B and 6 was significantly decreased in the gallbladders of mice in the EPA groups (70-90%) and the LD plus DHA group (30-50%), compared with that in the mice in the LD group. In addition, the mRNA expression of 3-hydroxy-3-methylglutaryl-coenzyme A reductase was significantly decreased in the livers of mice in the EPA treatment group compared with that in the livers of mice in the LD group. In conclusion, EPA was found to have a dominant anti-lithogenic effect in C57BL/6J mice. IntroductionEicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are essential fatty acids belonging to the group of ω-3 fatty acids, which are primarily found in coldwater fish. These polyunsaturated fatty acids (PUFAs) have an important role in the functions of the body and are converted into hormone-like substances known as prostaglandins and leukotrienes (1). EPA has been shown to provide health benefits in patients with coronary heart disease, high blood pressure, mental health conditions, such as schizophrenia, and inflammatory disorders, including rheumatoid arthritis (2-6). DHA is a key component of brain tissue and the retina of the eye (7,8). Low levels of DHA cause reduced serotonin levels in the brain, which may result in depression, attention deficit hyperactivity disorder, cognitive decline and Alzheimer's disease (9-11).It is well established that the key factors associated with cholesterol gallstone (CG) formation are biliary cholesterol hypersaturation and gallbladder mucin hypersecretion. The hypersaturation of cholesterol in the bile may result from a high-cholesterol diet or hepatic cholesterol overproduction. The elevation of biliary cholesterol concentration leads to the hypersecretion of mucin and the aggregation of cholesterol crystals (12,13). Several mucin (MUC) genes, including MUC2, MUC5AC, MUC5B and MUC6, are expressed in the gallbladder mucosa (14). The upregulation of these MUC genes leads to increased mucin concentrations, which increase bile viscosity and lead to the formation of a gel matrix that can entrap cholesterol crystals in the gallbladder (15-16).The only established medical treatment for CG is ursodeoxycholic acid (UDCA). However, a number of studies have demonstrated that the therapeutic efficacy exhibited by UDCA lacks consistency and is not entirely satisfactory (17-19). Despite numerous...

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Ground squirrel model for cholelithiasis: Role of epithelial glycoproteins

MacPherson

Pemsingh

1997

Microsc. Res. Tech.

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The cholesterol‐fed Richardson's ground squirrel (Spermophilus richardsonii) has proven to be an effective animal model in which to study factors that influence cholesterol gallstone formation and associated alterations in the gallbladder epithelium. Ground squirrels of either sex, fed a 2% cholesterol‐enriched diet, exhibit cholesterol monohydrate crystal precipitation within 24 hours and macroscopically visible cholesterol stones by 3 weeks. Data on bile chemistry, biliary cholesterol precipitation, and various mucosal alterations occurring prior to, during, and after stone formation were collected using sampling intervals from 6 hours to 20 weeks on the diet. The results indicate that mucin hypersecretion appears to be more closely related to the initiation of nucleation than does either bile calcium or pH. Mucus hypersecretion begins within 18 hours of diet initiation and continues throughout the 20 week experimental period. Apical excrescences became more common and were larger in size during the early stages of cholelithiasis. Administration of aspirin during the experimental period demonstrated an inhibition of mucin synthesis and release. Gallstones were not formed in these aspirin‐treated animals. A lectin‐binding panel for 10 epithelial glycoprotein‐related sugars indicated the mucin secreted by the gallbladder epithelium of 7 day experimental animals differed from that of controls. The most obvious difference was the abolition of WGA binding in the experimental animals, suggesting an absence of sialic acid expression in the mucin during the lithogenic process. Ultrastructural histochemistry indicated that both sulphomucin and sialomucin were present in the secretory granules and within the surface mucus layer of both experimental and control animals. Experimental animals, however, exhibited a significant predominance for sulphomucin. This pattern varies from that typically seen in other regions of the gastrointestinal tract where sialomucins predominate during pathologic processes. Microsc. Res. Tech. 39:39–55, 1997. © 1997 Wiley‐Liss, Inc.

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The Anatomy of Gallstones

Cited by 127 publications

References 4 publications

A histopathological and histochemical study of cholecystitis

A histopathological and histochemical study of cholecystitis

Effect of eicosapentaenoic acid on cholesterol gallstone formation in C57BL/6J mice

Ground squirrel model for cholelithiasis: Role of epithelial glycoproteins

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