Clinical evaluation of serum 3 beta-hydroxy-5-cholenoic acid in hepatobiliary diseases.
Serum 3 beta-hydroxy-5-cholenoic acid (3 beta-OH-delta 5) was analyzed in 100 cases (90 patients with hepatobiliary diseases, 10 normal subjects) and its clinical significance investigated. The measurement of 3 beta-OH-delta 5 was performed by high performance liquid chromatography (HPLC) with immobilized 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD) as the enzyme column. Esterified 3 beta-OH-delta 5 was measured after enzymatic hydrolysis with sulfatase and beta-glucuronidase. 3 beta-OH-delta 5 was hardly detected in normal cases. On the other hand, serum 3 beta-OH-delta 5 levels were remarkably high in cholestatic cases and also high in other cases with high bilirubin levels. The ratio of glycine- to taurine-conjugates (G/T ratio) was effective in discriminating cholestasis from hepatocellular damage such as in cases of acute hepatitis or fulminant hepatitis. More than 90% of the 3 beta-OH-delta 5, which is toxic, was sulfated or glucuronidated, suggesting detoxification by esterified bile acids. Significant increases of taurine-conjugated 3 beta-OH-delta 5 were observed in cases with pruritus, and a relationship between taurine-conjugated and pruritus was presumed. Therefore, analysis of 3 beta-OH-delta 5 is considered to be effective in clarifying the pathogenesis of hepatobiliary diseases.
Sugiyama
K
K
Okuyama
S
S
Imoto
M
M
Okumura
K
K
Takagi
K
K
Satake
T
T
D015096:3-Hydroxysteroid Dehydrogenases / Q000097:blood; D001647:Bile Acids and Salts / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001651:Cholestasis, Extrahepatic / Q000097:blood*; D002780:Cholestasis, Intrahepatic / Q000097:blood*; D002793:Cholic Acids / Q000097:blood*; D002851:Chromatography, High Pressure Liquid; D005966:Glucuronidase; D005998:Glycine / Q000378:metabolism; D006801:Humans; D006868:Hydrolysis; D008095:Lithocholic Acid / Q000097:blood; D008107:Liver Diseases / Q000097:blood*; D008111:Liver Function Tests; D011537:Pruritus / Q000097:blood; D013429:Sulfatases; D013654:Taurine / Q000378:metabolism
D001647:Bile Acids and Salts; D002793:Cholic Acids; D013654:Taurine; C014596:3 beta-hydroxy-delta 5-cholenic acid; D008095:Lithocholic Acid; D015096:3-Hydroxysteroid Dehydrogenases; D013429:Sulfatases; D005966:Glucuronidase; D001663:Bilirubin; D005998:Glycine