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Differential expression of cholangiocyte and ileal bile acid transporters following bile acid supplementation and depletion

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World Journal of Gastroenterology 2004年第10期10卷 1440-1446页

作者： N.Sertac Kip Konstantinos N.Lazaridis Anatoliy I.Masyuk Patrick L.Splinter Robert C.Huebert Nicholas F.LaRusso Center for Basic Research in Digestive Diseases Division of Gastroenterology and HepatologyDepartment of Internal MedicineMayo Medical SchoolClinic and FoundationRochesterMN 55905USA

AIM: We have previously demonstrated that cholangiocytes, the epithelial cells lining intrahepatic bile ducts,encode two functional bile acid transporters via alternative splicing of a single gene to facilitate bile acid vectorial transport. Cholangiocytes possess ASBT,an apical sodium-dependent bile acid transporter to take up bile acids,and t-ASBT,a basolateral alternatively spliced and truncated form of ASBT to efflux bile *** hepatocyte and ileal bile acid transporters are in part regulated by the flux of bile acids, the effect of alterations in bile acid flux on the expression of t-ASBT in terminal ileocytes remains ***,we tested the hypothesis that expression of ASBT and t-ASBT in cholangiocytes and ileocytes was regulated by bile acid flux. METHODS: Expression of ASBT and t-ASBT message and protein in cholangiocytes and ileocytes isolated from pair- fed rats given control (C) and 1% taurocholate (TCA) or 5% cholestyramine (CY) enriched diets,were assessed by both quantitative RNase protection assays and quantitative *** data obtained from each of the control groups were pooled to reflect the changes observed following TCA and CY treatments with respect to the control diets. Cholangiocyte taurocholate uptake was determined using a novel microperfusion technique on intrahepatic bile duct units (IBDUs) derived from C,TCA and CY fed rats. RESULTS: In cholangiocytes,both ASBT and t-ASBT message RNA and protein were significantly decreased in response to TCA feeding compared to C *** contrast, message and protein of both bile acid transporters significantly increased following CY feeding compared to C *** the ileum,TCA feeding significantly up-regulated both ASBT and t-ASBT message and protein compared to C diet,while CY feeding significantly down-regulated message and protein of both bile acid transporters compared to C *** anticipated from alterations in cholangiocyte ASBT expression,the uptake of taurocholate in microp

关键词： Cholestyramine dosage Ileum Taurocholic Acid Alternative Splicing Animals bile ducts Diet Eating Epithelial Cells Gene Expression Regulation Male Organic Anion Transporters, Sodium-Dependent Protein Isoforms Rats Rats, Inbred F344 Symporters

Mucin gene expression in bile of patients with and without gallstone disease,collected by endoscopic retrograde cholangiography

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World Journal of Gastroenterology 2009年第19期15卷 2367-2371页

作者： Alexander Vilkin Alex Geller Zohar Levi Yaron Niv Department of Gastroenterology Rabin Medical CenterBeilinson HospitalPetah Tiqwa and Sackler Faculty of MedicineTel Aviv UniversityTel Aviv49100Israel

AIM： To investigate the pattern of mucin expression and concentration in bile obtained during endoscopic retrograde cholangiography （ERC） in relation to gallstone ***： bile samples obtained at ERC from 29 consecutive patients, 17 with and 12 without gallstone disease were evaluated for mucin content by gel filtration on a Sepharose CL-4B column. Dot blot analysis for bile mucin apoproteins was performed with antibodies to Mucin 1 （MUC1）, MUC2, MUC3, MUC5AC, MUC5B and MUC6. Staining intensity score （0-3） was used as a measure of antigen ***： MUCl, MUC2, MUC3, MUCSAC, MUC5B and MUC6 were demonstrated in 34.4%, 34.4%, 51.7%, 51.7%, 55.1% and 27.5% of bile samples, *** staining intensity scores were 0.62 ± 0.94, 0.58 ± 0.90, 0.79 ± 0.97, 1.06 ± 1.22, 1.20 ± 2.26 and 0.41 ± 0.73, respectively. Mean mucin concentration measured in bile by the Sepharose CL-4B method was 22.8 ± 24.0 mg/mL （range 3.4-89.0 mg/mL）. Mean protein concentration was 8.1 ± 4.8 mg/mL （range 1.7-23.2 mg/mL）.CONCLUSION： High levels of MUC3, MUC5AC and MUC5B are expressed in bile aspirated during ERC examination. A specific pattern of mucin gene expression or change in mucin concentration was not found in gallstone disease.

关键词： bile bile ducts Endoscopic retrograde cholangiography Mucin

Modalities of testing Helicobacter pylori in patients with nonmalignant bile duct diseases

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World Journal of Gastroenterology 2002年第2期8卷 301-304页

作者： Milutin Bulajic Bojan Stimec Miroslav Milicevic Matthias Loehr Petra Mueller Ivan Boricic Nada Kovacevic Mirko Bulajic Department of Internal Medicine Clinical Center"Dr Dragisa Misovic"-DedinjeBelgradeYugoslavia Institute for Anatomy School of MedicineBelgrade Yugoslavia First Surgical Clinic Institute for digestive DiseasesUniversity Clinical CenterBelgradeYugoslavia Department of Medicine Ⅱ Medical Faculty MannheimUniversity of HeidelbergGermany Department of Medicine University of RostockGermany Institute for Pathology School of Medicine BelgradeYugoslavia Clinic for Gastroenterology and Hepatology Institute for Digestive DiseasesUniversity Clinical CenterBelgradeYugoslavia

AIM:This paper describes the procedure of detection of Helicobacter pylori(***)in bile specimens in patients suffering from benign diseases of biliary ducts(lithiasis with/without nonspecific cholangitis). METHODS:The group of 72 patients entering the study consisted of 32 male and 40 female(45 % and 55 %, respectively).bile was obtained during ERCP in 68 patients, and during cholecystectomy in 4 patients.A fast urease test (FUT)to determine the existence of *** in gastric mucosa was carried out for all the patients during the endoscopic *** existence of genetic material of *** was determined by detection of ure A gene by the method of nested *** results of this reaction were shown by electrophoresis on 10 g·L^(-1)agarose gel in a band of 256 bp. RESULTS:The majority of the patients included in our study had biliary lithiasis without signs of cholangitis(48 patients, 67 %),whereas other patients were complicated by cholangitis(17 patients,24 %).Seven patients(9 %)had normal ERCP,forming thus the control *** the group of patients with lithiasis 26 patients(24.2 %)had positive PCR of *** in bile and among the patients with associated cholangitis positive PCR was detected in 9 patients(52.9 %).Among the seven patients with normal ERCP only one(14 %)had positive PCR of ***.A high percentage of *** infection of gastric mucosa was observed(57 patients,79 %).It was also observed that its slightly higher positivity was in the patients with distinct bile pathology:81% FLIT positive patients in the group with choledocholithiasis alone and 76 % in the group with choledocholithiasis associated with ***-one percent of the patients with regular findings had positive ***: The prevalence of H. pylori infection both in bile and in gastric mucosa in patients with benign diseases of biliary ducts does not show a statistically significant difference in relation to the prevalence of the same with the patients

关键词： Adolescent Adult Aged Aged, 80 and over bile bile ducts Child Cholangiopancreatography, Endoscopic Retrograde Cholangitis Cholelithiasis Female Gastric Mucosa Helicobacter Infections Helicobacter pylori purification Humans Male Middle Aged Research Support, Non-U.S. Gov't Urease

Experimental models to study cholangiocyte biology

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World Journal of Gastroenterology 2002年第1期8卷 1-4页

作者： Pamela S.Tietz Robert C.Huebert Anatoliy Masyuk Tatyana Masyuk Patrick L.Splinter Nicholas F.LaRusso Center for Basic Research in Digestive Diseases Department of Internal Medicine and Biochemistry and Molecular BiologyMayo Medical SchoolClinic and FoundationRochesterMN 55905

Cholangiocytes-the epithelial cells which line the bileducts-are increasingly recognized as importanttransporting epithelia actively involved in the absorptionand secretion of water,ions,and *** is due in part to the recent development ofnew experimental *** biologic concepts haveemerged including the identification and topography ofreceptors and flux proteins on the apical and/orbasolateral membrane which are involved in the molecularmechanisms of ductal bile *** isolatedand/or perfused bile duct units from livers of rats andmice serve as new,physiologically relevant in vitromodels to study cholangiocyte *** treedimensions and novel insights into anatomic remodeling ofproliferating bile ducts have emerged from three-dimensional reconstruction using CT scanning andsophisticated ***,new pathologicconcepts have arisen regarding the interaction ofcholangiocytes with pathogens such as *** concepts and associated methodologiesmay provide the framework to develop new therapies forthe cholangiopathies,a group of important hepatobiliarydiseases in which cholangiocytes are the target cell.

关键词： Animals bile ducts Biological Transport Epithelial Cells Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Multiplanar reformations and minimum intensity projections using multi-detector row CT for assessing anomalies and disorders of the pancreaticobiliary tree

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World Journal of Gastroenterology 2007年第31期13卷 4177-4184页

作者： Hyun Cheol Kim Dal Mo Yang Wook Jin Chang Woo Ryu Jung Kyu Ryu Sung Il Park Seong Jin Park Hyeong Cheol Shin Il Young Kim Department of Radiology East-West Neo Medical Center Kyung-Hee University Seoul Republic of Korea Department of Diagnostic Radiology Kwandong University Myongji Hospital Goyang Republic of Korea Department of Diagnostic Radiology Soonchunhyang University Bucheon Hospital Bucheon Republic of Korea Department of Diagnostic Radiology Soonchunhyang University Cheonan Hospital Cheonan Republic of Korea

CT scan is regarded as the imaging modality of choice in patients with pancreaticobiliary ductal abnormalities. However, the axial orientation of the CT images provides only limited anatomical view of pancreaticobiliary ductal abnormalities. The technological advances of multi-de-tector row CT and three-dimensional image processing in workstations allows rapid image acquisition and a short postprocessing time. In particular, multiplanar reforma-tions (MPR) and minimum intensity projections (MinIP) offer rapid and accurate images of the anatomy and ab-normalities of the pancreaticobiliary tree. Moreover, MPR and MinIP help determine the relationship between the pancreaticobiliary ductal anatomy and the surrounding structures. This pictorial review illustrates the wide spec-trum of images obtained by the MPR and MinIP of the anomalies and disorders of the pancreaticobiliary tree.

关键词： Multi-detector CT bile ducts Biliary System Pancreas Computer Applications-3D

Optimal biliary drainage for inoperable Klatskin's tumor based on Bismuth type

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World Journal of Gastroenterology 2007年第29期13卷 3948-3955页

作者： Sang Hyub Lee Joo Kyung Park Won Jae Yoon Jun Kyu Lee Ji Kon Ryu Yong Bum Yoon Yong-Tae Kim Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine Seoul South Korea

AIM： To investigate differences in the effects of biliary drainage procedures in patients with inoperable Klatskin＇s tumor based on Bismuth type, considering endoscopic retrograde biliary drainage （ERBD）, external percutaneous transhepatic biliary drainage （EPTBD） and internal biliary stenting via the PTBD tract （IPTBD）. METHODS： The initial success rate, cumulative patency rate, and complication rate were compared retrospectively, according to the Bismuth type and ERBD, EPTBD, and IPTBD. Patency was defined as the duration for adequate initial bile drainage or to the point of the patient＇s death associated with inadequate drainage. RESULTS： One hundred thirty-four patients （93 men, 41 women; 21 Bismuth type Ⅱ, 47Ⅲ, 66 Ⅳ; 34 ERBD, 66 EPTBD, 34 IPTBD） were recruited. There were no differences in demographics among the groups. Adequate initial relief of jaundice was achieved in 91% of patients without a significant difference in the results among different procedures or Bismuth types. The cumulative patency rates for ERBD and IPTBD were better than those for EPTBD with Bismuth type Ⅲ. IPTBD provided an excellent response for Bismuth type IV. However, there was no difference in the patency rate among drainage procedures for Bismuth type Ⅱ. Procedure-related cholangitis occurred less frequently with EPTBD than with ERBD and IPTBD. CONCLUSION： ERBD is recommended as the firstline drainage procedure for the palliation of jaundice in patients with inoperable Klatskin＇s tumor of Bismuth type Ⅱ or Ⅲ, but IPTBD is the best option for Bismuth type Ⅳ.

关键词： Klatskin's tumor Palliation Drainage bile ducts Intervention

Graft cholangiopathy: etiology, diagnosis, and therapeutic strategies

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Hepatobiliary & Pancreatic Diseases International 2014年第1期13卷 10-17页

作者： Ying Luo Wen-Bin Ji Wei-Dong Duan Sheng Ye Jia-Hong Dong Department of Hepatobiliary Surgery Chinese PLA General Hospital

BACKGROUND: Graft cholangiopathy has been recognized as a significant cause of morbidity, graft loss, and even mortality in patients after orthotopic liver transplantation. The aim of this review is to analyze the etiology, pathogenesis, diagnosis and therapeutic strategies of graft cholangiopathy after liver transplantation. DATA SOURCE: A PubMed database search was performed to identify articles relevant to liver transplantation, biliary complications and cholangiopathy. RESULTS: Several risk factors for graft cholangiopathy after liver transplantation have been identified, including ischemia/ reperfusion injury, cytomegalovirus infection, immunological injury and bile salt toxicity. A number of strategies have been attempted to prevent the development of graft cholangiopathy, but their efficacy needs to be evaluated in large clinical studies. Non-surgical approaches may offer good results in patients with extrahepatic lesions. For most patients with complex hilar and intrahepatic biliary abnormalities, however, surgical repair or re-transplantation may be required. CONCLUSIONS: The pathogenesis of graft cholangiopathy after liver transplantation is multifactorial. In the future, more efforts should be devoted to the development of more effective preventative and therapeutic strategies against graft cholangiopathy.

关键词： liver transplantation bile ducts complications ischemia/reperfusion injury therapy

Selection criteria for preoperative endoscopic retrograde cholangiopancreatography before laparoscopic cholecystectomy and endoscopic treatment of bile duct stones:Results of a retrospective,single center study between 1996-2002

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World Journal of Gastroenterology 2004年第23期10卷 3495-3499页

作者： Laszlo Lakatos Gabor Mester Gyorgy Reti Attila Nagy Peter Laszlo Lakatos 1~(st)Department of Medicine Csolnoky FProvince HospitalVeszpremH-8200 Hungary Department of Surgery Csolnoky FProvince HospitalVeszpremH-8200 Hungary 1~(st)Department of Medicine Semmelweis UniversityBudapestH-8200 Hungary

AIM: The optimal treatment for bile duct stones (in terms of cost, complications and accuracy) is unclear. The aim of our study was to determine the predictive factors for preoperative endoscopic retrograde cholangiopancreatography (ERCP).METHODS: Patients undergoing preoperative ERCP (≤90 d before laparoscopic cholecystectomy) were evaluated in this retrospective study from the 1^st of January 1996 to the 31^st of December 2002. The indications for ERCP were elevated serum bilirubin, elevated liver function tests (LFT), dilated bile duct (≥8 mm) and/or stone at US examination, coexisting acute pancreatitis and/or acute pancreatitis or jaundice in patient's history. Suspected prognostic factors and the combination of factors were compared to the result of ERCRRESULTS: Two hundred and six preoperative ERCPs were performed during the observed period. The rate of successful cannulation for ERC was (97.1%). bile duct stones were detected in 81 patients (39.3%), and successfully removed in 79 (97.5%). The number of prognostic factors correlated with the presence of bile duct stones. The positive predictive value for one prognostic factor was 1.2%, for two 43%,for three 72.5%, for four or more 91.4%.CONCLUSION: Based on our data preoperative ERCP is highly recommended in patients with three or more positive factors (high risk patients). In contrast, ERCP is not indicated in patients with zero or one factor (low risk patients).Preoperative ERCP should be offered to patients with two positive factors (moderate risk patients), however the practice should also be based on the local conditions (*** of the endoscopist, other diagnostic tools).

关键词： Cholangiopancreatography, Endoscopic Retrograde Cholecystectomy, Laparoscopic Patient Selection bile ducts Cholelithiasis Female Humans Male Middle Aged Predictive Value of Tests Preoperative Care Retrospective Studies

Postoperative biliary adverse events following orthotopic liver transplantation: Assessment with magnetic resonance cholangiography

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World Journal of Gastroenterology 2014年第32期20卷 11080-11094页

作者： Piero Boraschi Francescamaria Donati 2nd Unit of Radiology Department of Diagnostic Radiology Vascular and Interventional Radiology and Nuclear Medicine Pisa University Hospital56124 Pisa Italy

Biliary adverse events following orthotopic liver transplantation (OLT) are relatively common and continue to be serious causes of morbidity, mortality, and transplant dysfunction or failure. The development of these adverse events is heavily influenced by the type of anastomosis during surgery. The low specificity of clinical and biologic findings makes the diagnosis challenging. Moreover, direct cholangiographic procedures such as endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography present an inadmissible rate of adverse events to be utilized in clinically low suspected patients. Magnetic resonance (MR) maging with MR cholangiopancreatography is crucial in assessing abnormalities in the biliary system after liver surgery, including liver transplant. MR cholangiopancreatography is a safe, rapid, non-invasive, and effective diagnostic procedure for the evaluation of biliary adverse events after liver transplantation, since it plays an increasingly important role in the diagnosis and management of these events. On the basis of a recent systematic review of the literature the summary estimates of sensitivity and specificity of MR cholangiopancreatography for diagnosis of biliary adverse events following OLT were 0.95 and 0.92, respectively. It can provide a non-invasive method of imaging surgical reconstruction of the biliary anastomoses as well as adverse events including anastomotic and non-anastomotic strictures, biliary lithiasis and sphincter of Oddi dysfunction in liver transplant recipients. Nevertheless, conventional T2-weighted MR cholangiography can be implemented with T1-weighted contrast-enhanced MR cholangiography using hepatobiliary contrast agents (in particular using Gd-EOB-DTPA) in order to improve the diagnostic accuracy in the adverse events’ detection such as bile leakage and strictures, especially in selected patients with biliary-enteric anastomosis.

关键词： Liver transplantation bile ducts Biliary adverse events Magnetic resonance cholangiography Contrast-enhanced magnetic resonance cholangiography