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Superior gallstone dissolubility and safety of tert-amyl ethyl ether over methyl-tertiary butyl ether

World Journal of Gastroenterology 2019年第39期25卷 5936-5952页

作者： Dong Do You Suk Joon Cho Ok-Hee Kim Jin Sook Song Kyu-Seok Hwang Sang Chul Lee Kee-Hwan Kim Ho Joong Choi Ha-Eun Hong Haeyeon Seo Tae Ho Hong Jung Hyun Park Tae Yoon Lee Joseph Ahn Jae-Kyung Jung Kwan-Young Jung Say-June Kim Department of Surgery St.Vincent's HospitalCollege of MedicineThe Catholic University of KoreaSeoul 16247South Korea College of Pharmacy Chungbuk National UniversityCheongju 28644South Korea Department of Surgery Seoul St.Mary’s HospitalCollege of Medicinethe Catholic University of KoreaSeoul 06591South Korea Catholic Central Laboratory of Surgery Institute of Biomedical IndustryCollege of Medicinethe Catholic University of KoreaSeoul 06591South Korea Bio and Drug Discovery Division Korea Research Institute of Chemical TechnologyDaejeon 34114South Korea Department of Surgery Daejeon St.Mary's HospitalCollege of Medicinethe Catholic University of KoreaSeoul 34943South Korea Department of Surgery Uijeongbu St.Mary's HospitalCollege of Medicinethe Catholic University of KoreaSeoul 11765South Korea Department of Biomedicine and Health Science College of Medicinethe Catholic University of KoreaSeoul 06591South Korea Department of Surgery Eunpyeong St.Mary’s HospitalCollege of Medicinethe Catholic University of KoreaSeoul 03312South Korea Department of Medicinal Chemistry and Pharmacology University of Science and TechnologyDaejeon 34113South Korea

BACKGROUND The use of methyl-tertiary butyl ether(MTBE)to dissolve gallstones has been limited due to concerns over its toxicity and the widespread recognition of the safety of laparoscopic cholecystectomy.The adverse effects of MTBE are largely attributed to its low boiling point,resulting in a tendency to evaporate.Therefore,if there is a material with a higher boiling point and similar or higher dissolubility than MTBE,it is expected to be an attractive alternative to MTBE.AIM To determine whether tert-amyl ethyl ether(TAEE),an MTBE analogue with a relatively higher boiling point(102°C),could be used as an alternative to MTBE in terms of gallstone dissolubility and toxicity.METHODS The in vitro dissolubility of MTBE and TAEE was determined by measuring the dry weights of human gallstones at predetermined time intervals after placing them in glass containers with either of the two solvents.The in vivo dissolubility was determined by comparing the weights of solvent-treated gallstones and control(dimethyl sulfoxide)-treated gallstones,after the direct infusion of each solvent into the gallbladder in both hamster models with cholesterol and pigmented gallstones.RESULTS The in vitro results demonstrated a 24 h TAEE-dissolubility of 76.7%,56.5%and 38.75%for cholesterol,mixed,and pigmented gallstones,respectively,which represented a 1.2-,1.4-,and 1.3-fold increase in dissolubility compared to that of MTBE.In the in vitro experiment,the 24 h-dissolubility of TAEE was 71.7%and 63.0%for cholesterol and pigmented gallstones,respectively,which represented a 1.4-and 1.9-fold increase in dissolubility compared to that of MTBE.In addition,the results of the cell viability assay and western blot analysis indicated that TAEE had a lower toxicity towards gallbladder epithelial cells than MTBE.CONCLUSION We demonstrated that TAEE has higher gallstone dissolubility properties and safety than those of MTBE.As such,TAEE could present an attractive alternative to MTBE if our findings regarding its efficacy and safety can be consist

关键词： tert-amyl ethyl ether Gallstones Methyl-tert-butyl ether Contact litholytic agent

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