(1)H and (31)P NMR studies indicate reduced bile constituents in patients with biliary obstruction and infection.
Patients with extrahepatic biliary obstruction present with impairment of the normal bile flow, with jaundice and cholangitis as common complications. (1)H and (31)P NMR quantitative analysis of bile specimens from patients with extrahepatic biliary obstruction (n = 80) (with/without jaundice and cholangitis separately and together) was carried out for the chief biliary constituents to determine the relationship between biliary constituents and jaundice (serum bilirubin concentration >or=1.0 mg/dL) and cholangitis (total leucocyte count >11,000 cells/mm(3) and/or fever >38.5 degrees C with/without bile culture positivity). Compared with controls (patients without jaundice and cholangitis), median indices of the chief biliary constituents (total bile acids, cholesterol, phosphatidylcholine and inorganic phosphate) were significantly suppressed in patients with cholangitis and/or jaundice. Quantities of total bile acids, cholesterol and phosphatidylcholine correlated negatively with the quantity of bilirubin and with cholangitis, i.e. total leucocyte count. Suppression of biliary constituents correlated significantly with the severity of jaundice and cholangitis. The decrease in biliary constituents in the presence of jaundice and cholangitis is possibly the result of downregulation of the function of transporters located at the canalicular side of hepatocytes, leading to their suppressed indices in bile. This information may have implications in the examination of bile for clinical studies.
Center of Biomedical Magnetic Resonance, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Lakshmi
L
Bala
Pratima
P
Tripathi
Ganesh
G
Bhatt
Kshaunish
K
Das
Raja
R
Roy
Gourdas
G
Choudhuri
C L
CL
Khetrapal
D000328:Adult; D000368:Aged; D001646:Bile / Q000737:chemistry*; D015415:Biomarkers / Q000032:analysis; D002761:Cholangitis / Q000175:diagnosis* / Q000378:metabolism*; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010759:Phosphorus Isotopes; D011522:Protons; D012680:Sensitivity and Specificity; D055815:Young Adult
D015415:Biomarkers; D010759:Phosphorus Isotopes; D011522:Protons