Total protein content of human gallbladder bile: relation to cholesterol gallstone disease and effects of treatment with bile acids and aspirin.
OBJECTIVE
To measure the total protein content of gallbladder bile, and assess how treatment with aspirin and the gallstone solvents chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA) affects the biliary protein concentration.


METHODS
Prospective study.


METHODS
Teaching hospital, Sweden.


METHODS
102 Consecutive patients undergoing cholecystectomy for cholesterol gallstones (n = 73) or adenomyomas or cholesterolosis in the gallbladder wall (n = 29). Thirty of the patients with gallstones were treated with CDCA, UDCA or aspirin.


METHODS
Aspiration of bile from the gallbladder during operation.


METHODS
Protein content, and correlations between protein content and biliary lipids, cholesterol saturation and crystals, and concentrations of individual bile acids.


RESULTS
There were no differences in total protein content among the groups except for the UDCA treated group, which had significantly less protein 2.1 (0.5) g/l compared with 6.1 (0.5) for untreated gallstones, 5.8 (0.9) for those treated with CDCA, 6.8 (1.2) for those treated with aspirin and 7.3 (0.7) for those with no gallstones). There were no differences between bile with and without crystals. There was a positive correlation between the protein content and biliary cholesterol concentration and saturation. Aspirin did not influence the total protein content in the bile.


CONCLUSIONS
The total protein concentration in gallbladder bile was similar in patients with and without cholesterol crystals, which might indicate that the total protein content in bile does not influence formation of cholesterol crystals and consequently not the formation of gallstones. Patients treated with UDCA were the only group that had significantly less protein than the other groups, which indicates that the mode of action of UDCA is different from that of CDCA.
Sahlin
S
S
Department of Surgery, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.
D001241:Aspirin / Q000627:therapeutic use*; D001646:Bile / Q000737:chemistry*; D002635:Chenodeoxycholic Acid / Q000627:therapeutic use*; D002769:Cholelithiasis / Q000737:chemistry / Q000188:drug therapy / Q000378:metabolism*; D002784:Cholesterol / Q000032:analysis*; D005260:Female; D006801:Humans; D008055:Lipids / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011506:Proteins / Q000032:analysis*; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D008055:Lipids; D011506:Proteins; D002635:Chenodeoxycholic Acid; D014580:Ursodeoxycholic Acid; D002784:Cholesterol; D001241:Aspirin