title: Increased biliary group II phospholipase A2 and altered gallbladder bile in patients with multiple cholesterol stones.
abstract: OBJECTIVE
  Multiple cholesterol stones are associated with more biliary complications and show more rapid cholesterol nucleation than solitary stones. Group II phospholipase A2 (PLA2-II) may play a critical role in the process of mucosal inflammation, which in turn may produce pronucleating agents. PLA2-II concentrations in gallbladders and gallbladder bile from patients with different types of gallstone disease were assayed to correlate PLA2-II with alterations in biliary composition.
  
  
  METHODS
  PLA2-II protein concentrations were assayed immunoradiometrically using monoclonal antibodies against human splenic PLA2-II.
  
  
  RESULTS
  Immunoreactive PLA2-II levels in gallbladder bile were significantly higher in patients with multiple cholesterol stones (68.2 +/- 6.3 ng/dL, mean +/- SEM; n = 24) than in those with solitary stones (24.9 +/- 2.8; n = 20; P < 0.01), those with multiple pigment stones (24.2 +/- 3.7; n = 18; P < 0.01), or control subjects (13.4 +/- 1.7; n = 19; P < 0.01). Increased biliary immunoreactive PLA2-II levels in multiple cholesterol stones were associated with a concomitant increase in the lysophosphatidylcholine to phosphatidylcholine ratio; free arachidonate, protein, and hexosamine concentrations; and gallbladder bile viscosity. The gallbladders showed an increased PLA2-II protein mass and steady-state messenger RNA levels, which was associated with increased prostaglandin E2 levels.
  
  
  CONCLUSIONS
  Increased biliary PLA2-II may be of pathogenetic importance in multiple cholesterol stones, probably through potentiating gallbladder mucosal inflammation with associated biliary alterations favoring cholesterol crystal formation.
authors.affiliation: Department of Gastroenterology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Shoda
authors.forename: T
authors.initials: T
authors.lastname: Ueda
authors.forename: T
authors.initials: T
authors.lastname: Ikegami
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuzaki
authors.forename: S
authors.initials: S
authors.lastname: Satoh
authors.forename: M
authors.initials: M
authors.lastname: Kano
authors.forename: K
authors.initials: K
authors.lastname: Matsuura
authors.forename: N
authors.initials: N
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D001646:Bile / Q000378:metabolism*; D002769:Cholelithiasis / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D010741:Phospholipases A / Q000378:metabolism*; D054467:Phospholipases A2; D011863:Radioimmunoassay
chemical_list: D010741:Phospholipases A; D054467:Phospholipases A2