title: A comparative study of microstructural development in paired human hepatic and gallbladder biles.
abstract: Cholesterol gallstones usually develop in the gallbladder and rarely form in bile ducts even in patients with highly lithogenic bile. Bile concentration and proteins (e.g. mucin) may affect crystallization, but the exact nature of this effect, especially in relation to crystallization pathways and microstructural evolution remains unclear. We examined lipid microstructures in paired hepatic and gallbladder biles to reveal ones that are essential for crystallization. Combining digital light microscopy with cryogenic-temperature transmission electron microscopy we are able to directly visualize and compare the time evolution of lipid microstructures in paired hepatic, gallbladder and diluted gallbladder biles of gallstone patients and controls, without drying or separating. Gallbladder bile exhibited several multilamellar vesicles and spheroidal micelles preceding and throughout crystallization. Vesicle morphology changed before crystallization was observed. In contrast, hepatic bile revealed almost no crystallization and while a variety of unilamellar vesicles and spheroidal micelles existed throughout the examination, multilamellar vesicles were rare. Diluted gallbladder bile was different from native gallbladder bile, as well as the paired hepatic bile, yielding occasional crystallization. Our findings suggest that maturing multilamellar vesicles precede (and at least partially initiate) crystallization in gallbladder bile. Although microstructural development seems to be concentration dependent, dilution of gallbladder bile to hepatic bile concentrations neither makes it identical to hepatic bile, nor prevents crystallization.
authors.affiliation: Faculty of Chemical Engineering, Technion-Israel Institute of Technology, Haifa 32000, Israel. daphnew@tx.technion.ac.il
authors.forename: Daphne
authors.initials: D
authors.lastname: Weihs
authors.forename: Judith
authors.initials: J
authors.lastname: Schmidt
authors.forename: Dganit
authors.initials: D
authors.lastname: Danino
authors.forename: Ilana
authors.initials: I
authors.lastname: Goldiner
authors.forename: Diana
authors.initials: D
authors.lastname: Leikin-Gobbi
authors.forename: Arieh
authors.initials: A
authors.lastname: Eitan
authors.forename: Moshe
authors.initials: M
authors.lastname: Rubin
authors.forename: Yeshayahu
authors.initials: Y
authors.lastname: Talmon
authors.forename: Fred M
authors.initials: FM
authors.lastname: Konikoff
mesh_terms: D001646:Bile / Q000737:chemistry* / Q000378:metabolism; D001647:Bile Acids and Salts / Q000737:chemistry; D002784:Cholesterol / Q000737:chemistry / Q000378:metabolism; D003460:Crystallization; D005704:Gallbladder / Q000378:metabolism*; D006801:Humans; D008055:Lipids / Q000737:chemistry; D008099:Liver / Q000378:metabolism*; D008823:Micelles; D008853:Microscopy / Q000379:methods; D046529:Microscopy, Electron, Transmission; D013696:Temperature
chemical_list: D001647:Bile Acids and Salts; D008055:Lipids; D008823:Micelles; D002784:Cholesterol