The role of bile acid secretion in the hepatic response to operation and infection.
Hepatic function is altered in many surgery-related diseases. Bile acid secretion is the major determinant of bile formation and an important indicator of overall hepatic function. To investigate the cause of intrahepatic cholestasis, which is frequently associated with sepsis, we studied the effects of cecal ligation and puncture (CLP) and surgical stress on bile acid secretion and composition. CLP or a sham operation was performed on 20 male Sprague-Dawley rats. Bile was collected from each rat by cannulation of the common bile duct for 10-minute intervals, at 5 and 20 hours after the initial procedure. Bile acid analysis was then performed by high performance liquid chromatography (HPLC). In CLP rats, there was a significant (P < 0.05) cholestatic effect. Bile flow was reduced to 70 +/- 13 per cent at 5 hours, and to 55 +/- 16 per cent at 20 hours (per cent of the sham mean value). In the sham-operated rats, there was a significant choleresis at 20 hours. Bile flow was increased to 146 +/- 13 per cent; bile acid secretion to 245 +/- 24 per cent; and total bile acid concentration to 175 +/- 19 per cent of the sham 5-hour value (P < 0.05). This increased secretion was significantly greater in the metabolites of chenodeoxycholate. However, these surgical stress-associated changes in bile acid secretion and composition did not occur in CLP rats. These findings are consistent with surgical stress-induced induction of 7 alpha-hydroxylase, which was not found in the septic animals. These observations may provide useful insights into the early stages of the pathogenesis of sepsis-related hepatic dysfunction and failure.
Reynolds
M A
MA
Department of Surgery, University of Louisville School of Medicine, KY 40292, USA.
Siow
Y
Y
Collet
D
D
Klar
E
E
Richardson
J D
JD
Vitale
G C
GC
D000818:Animals; D001647:Bile Acids and Salts / Q000032:analysis / Q000378:metabolism*; D002432:Cecum / Q000601:surgery; D002780:Cholestasis, Intrahepatic / Q000209:etiology* / Q000503:physiopathology; D002851:Chromatography, High Pressure Liquid; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D018805:Sepsis / Q000150:complications*; D013312:Stress, Physiological / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors
D001647:Bile Acids and Salts