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Ceci L, Han Y, Krutsinger K, Baiocchi L, Wu N, Kundu D, Kyritsi K, Zhou T, Gaudio E, Francis H, Alpini G, Kennedy L. Gallstone and Gallbladder Disease: Biliary Tract and Cholangiopathies. Compr Physiol 2023; 13:4909-4943. [PMID: 37358507 DOI: 10.1002/cphy.c220028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Cholestatic liver diseases are named primarily due to the blockage of bile flow and buildup of bile acids in the liver. Cholestasis can occur in cholangiopathies, fatty liver diseases, and during COVID-19 infection. Most literature evaluates damage occurring to the intrahepatic biliary tree during cholestasis; however, there may be associations between liver damage and gallbladder damage. Gallbladder damage can manifest as acute or chronic inflammation, perforation, polyps, cancer, and most commonly gallstones. Considering the gallbladder is an extension of the intrahepatic biliary network, and both tissues are lined by biliary epithelial cells that share common mechanisms and properties, it is worth further evaluation to understand the association between bile duct and gallbladder damage. In this comprehensive article, we discuss background information of the biliary tree and gallbladder, from function, damage, and therapeutic approaches. We then discuss published findings that identify gallbladder disorders in various liver diseases. Lastly, we provide the clinical aspect of gallbladder disorders in liver diseases and ways to enhance diagnostic and therapeutic approaches for congruent diagnosis. © 2023 American Physiological Society. Compr Physiol 13:4909-4943, 2023.
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Affiliation(s)
- Ludovica Ceci
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| | - Yuyan Han
- School of Biological Sciences, University of Northern Colorado, Greeley, Colorado, USA
| | - Kelsey Krutsinger
- School of Biological Sciences, University of Northern Colorado, Greeley, Colorado, USA
| | | | - Nan Wu
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Debjyoti Kundu
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Konstantina Kyritsi
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Tianhao Zhou
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Eugenio Gaudio
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| | - Heather Francis
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Research, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA
| | - Gianfranco Alpini
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Research, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA
| | - Lindsey Kennedy
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Research, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA
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Sharma B, Sharma SR. Microstructural and heavy metal analysis of gallstones prevalent in Jharkhand and its implications in the treatment. Postgrad Med 2023; 135:296-311. [PMID: 36317754 DOI: 10.1080/00325481.2022.2139973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES In the present study the structural and compositional analysis of gallstones was carried out by various characterization techniques. Also, the utility of the study was evaluated on how the findings can enhance the treatment and dissolution therapies of gallstones? METHODS Gallstones from the Jharkhand region were analyzed both structurally as well as chemically using Field emission scanning electron microscope (FESEM) and Energy-dispersive X-ray spectroscopy, inductively coupled optical emission spectrometry (ICP-OES), Carbon hydrogen and nitrogen analyzer (CHNS), Nuclear magnetic resonance (NMR), Thermal gravimetric analysis (TGA) and Differential Thermal Analysis (DTA) and other instruments. The content of heavy metal was represented statistically as a mean with standard deviation. RESULTS FESEM analysis unveiled the crystal and globular structure of cholesterol and pigment gallstones respectively. Through ICP-OES analysis metals such as Fe, Mn, Cu, Pb, Cr, Zn etc. were detected in gallstones. FTIR and XRD analysis confirmed the presence of cholesterol and calcium carbonate and other compounds in mixed stones and calcium bilirubinate and bilirubin in pigment gallstones. NMR analysis revealed the presence of monohydrate cholesterol (Crystalline) in Cholesterol and mixed gallstones. Mixed gallstones were found to be predominant in this region in contrast to pigmented stones that were prevalent earlier. CONCLUSION The present study uncovered the current composition and content of different heavy metals in gallstones of Jharkhand region which can be instrumental in enhancing the dissolution therapies for gallstone treatment. This can serve as a major tool for practitioners for gallstone treatment and change the way they are looked at.
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Affiliation(s)
- Bhavna Sharma
- Department of Bioengineering and Biotechnology, Birla Institute of Technology, Mesra, Ranchi, India
| | - Shubha Rani Sharma
- Department of Bioengineering and Biotechnology, Birla Institute of Technology, Mesra, Ranchi, India
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Bali V, Khajuria Y, Sharma J, Rai PK, Gondal MA, Kumar U, Singh VK. Compositional and Morphological Studies of Kidney and Gallbladder Stones from Fundamentals to Advanced Level using SEM–EDS Technique: A Short Review. ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 2022. [DOI: 10.1007/s13369-022-07324-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Daudon M, Lionnet F, Loi V, Amiot X, Boury A, Haymann JP, Bazin D. Features of gallstones in adult sickle cell patients. CR CHIM 2022. [DOI: 10.5802/crchim.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sharma B, Sharma SR. Evaluation of gallstone classification and their diagnosis through serum parameters as emerging tools in treatment: a narrative review. Postgrad Med 2022; 134:644-653. [PMID: 35841159 DOI: 10.1080/00325481.2022.2103350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The treatment of gallstones is a matter of real concern as they may cause gallbladder cancer if not properly attended to. Evaluating the classification of gallstones can give major clues in their treatment as it will decide their aetiology, chemical composition, and pathogenesis. Also, serum parameters have emerged as an efficient tool for diagnosing gallstones. They can be probed to evaluate different biochemicals and the changes in their levels in gallstone patients which can be correlated with early prediction of the formation of gallstones. In the present review, a thorough search of the available literature was done starting from the earliest approaches for the classification of gallstones up to the recent advancements. The alteration in the level of serum parameters was also studied in gallstone patients so that it can act as a potential diagnostic tool for early detection of gallstone formation. The earliest classification of gallstones was done in 1896 by Nauyn. He classified them into pure cholesterol stones, laminated cholesterol stones, ordinary gallbladder stones, mixed bilirubin stones, and rare forms. The most recent classification of gallstones was done by Peter et al in 2020 and they classified them as pure, mixed, composite cholesterol, carbonate stones, black and brown pigment stones. The altered of levels of serum parameters was analyzed by Reuben (1985) and in recent times by Peter et al (2020). The various serum parameters studied were as RDW-CV test (red blood cell distribution width), PCT (prolactin) test, MPV (mean platelet count), LYM (lymphocyte) test, and EOS (eosinophil and eosinophil count test). Also, we discussed some practical considerations for gallstones that can be taken into account for gallstone prevention and diagnosis. Further research is required to detect gallstone type in the gallbladder by using the alteration in the levels of serum parameters.
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Affiliation(s)
- Bhavna Sharma
- Department of Bio-engineering and Biotechnology, Birla Institute of Technology, Mesra, Jharkhand, India
| | - Shubha Rani Sharma
- Department of Bio-engineering and Biotechnology, Birla Institute of Technology, Mesra, Jharkhand, India
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Sharma R, Kumar K, Tanvi K. Dealkenylation of neoandrographolide, a phytochemical from Andrographis paniculata stimulates FXR (Farnesoid X Receptor) and enhances gallstone dissolution. J Biomol Struct Dyn 2022; 41:3339-3348. [PMID: 35253613 DOI: 10.1080/07391102.2022.2048078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
FXR (Farnesoid X Receptor) is one of the nuclear receptors expressed in the liver performing a significant role in the maintenance of bile acid concentration. An imbalance of cholesterol and bile acid ratio due to any undefined reason could cause gallstone formation. Hence, this paper aims to screen phytochemicals that could maintain a requisite balance of cholesterol and bile acid by targeting FXR and thereby contributing to the dissolution of gallstone. Nineteen phytochemicals were selected and queried for Pa and Pi in the way2drug online server for hepatoprotective property, cholesterol synthesis and absorption inhibition property, and β-glucuronidase inhibiting activity. Cianidanol, neoandrographolide, cynarine, saponins, and tanins with satisfying stated properties were docked with the screened FXR (PDB ID- 1OSH) using HADDOCK server, followed by pharmacokinetics study utilizing SwissADME tool. Neoandrographolide fits best among the other selected literature-based phytochemicals with minor violation of 'Brenk's rule'. The violation was corrected with the removal of an alkene group in the provided ChemDraw space of SwissADME. This Dealkenylated compound was further docked with FXR. The promising response under the static condition of the Dealkenylated compound was analyzed for molecular dynamic simulation at physiological conditions for 100 ns. Dealkenylated Neoandrographolide (DN) exhibited hepatoprotective, cholesterol synthesis and absorption inhibition property, and β-glucuronidase inhibition activity with a superior binding score of -42.6+/-1.5 with FXR. The interaction of the FXR receptor and the DN showed exceptional stability at physiological conditions during MD simulation and fit for the ADME properties, therefore it could be a potent candidate to dissolve gallstones.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Rajani Sharma
- Amity Institute of Biotechnology, Amity University Jharkhand, Ranchi, India
| | - Kunal Kumar
- Amity Institute of Biotechnology, Amity University Jharkhand, Ranchi, India
| | - Kumari Tanvi
- Amity Institute of Biotechnology, Amity University Jharkhand, Ranchi, India
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Analysis of stones formed in the human gall bladder and kidney using advanced spectroscopic techniques. Biophys Rev 2020; 12:647-668. [PMID: 32410185 DOI: 10.1007/s12551-020-00697-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/30/2020] [Indexed: 02/07/2023] Open
Abstract
Stone diseases (gallstones and kidney stones) are extremely painful and often cause death. The prime aim of biomedical research in this area has been determination of factors resulting in stone formation inside the gallbladder and urinary tract. Many theories have been put forward to explain the mechanism of stone formation and their growth; however, their complete cycle of pathogenesis is still under debate. Several factors are responsible for stone formation; however, much emphasis is placed on the determination of elemental and molecular composition of the stones. In the present review article, we describe different kinds of spectroscopic techniques such as Fourier transform infrared spectroscopy (FTIR), X-ray fluorescence (XRF) spectroscopy, time-of-flight secondary ion mass spectrometry (TOF-SIMS), and laser-induced breakdown spectroscopy (LIBS) and highlight their use in the analysis of stone diseases. We have summarized work done on gallstones and kidney stones using these advanced techniques particularly over the last 10 years. We have also briefly elaborated the basics of stone formations inside the human body and their complications for a better understanding of the subject.
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Peter A, Cozmuta LM, Nicula C, Cozmuța AM, Vulpoi A, Barbu-Tudoran L, Magyari K, Todea M, Baia L, Pop FG. Multi-analyses of gallstones and correlation between their properties with the laboratory results. Anal Biochem 2020; 593:113587. [PMID: 31978457 DOI: 10.1016/j.ab.2020.113587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/20/2019] [Accepted: 01/15/2020] [Indexed: 10/25/2022]
Abstract
This study explores the morpho-structure of gallstones (GSs) removed from 36 patients in NW Romania and correlate it with the laboratory results of the patients. GSs were analyzed by SEM-EDS, X-ray diffraction and IR, UV-Vis and X-ray photoelectron spectroscopy. The laboratory studies consisted in hematological, coagulation, biochemistry, immunological and tumor markers tests. The morphological and structural investigations allowed to classify the GS in five different types and to establish their mechanism of formation. Only macroscopic evaluation, SEM microscopy, FTIR and UV-Vis spectroscopy give different easily noticeable information for each GS type. EDS, XPS and XRD diffraction are recommended to distinguish pigment and carbonate stones from the other GS types and a carefully examination is needed to establish the differences between the pure cholesterol, the mixed cholesterol and the composite cholesterol stones, due to the high similarities. The variation of specific markers cannot differentiate the patients with pure cholesterol GS from those with mixed cholesterol and pigment GS and those with mixed cholesterol from those with composite cholesterol stones. Seven laboratory parameters (RDW-CV, MPV, PCT, GLUC-HK, WBC, PT, GPT) are the key indicators for the GS disease and trend to present generally higher values than normal.
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Affiliation(s)
- Anca Peter
- Technical University of Cluj Napoca, Department of Chemistry and Biology, Victor Babes 76, 430083, Baia Mare, Romania.
| | - Leonard Mihaly Cozmuta
- Technical University of Cluj Napoca, Department of Chemistry and Biology, Victor Babes 76, 430083, Baia Mare, Romania.
| | - Camelia Nicula
- Technical University of Cluj Napoca, Department of Chemistry and Biology, Victor Babes 76, 430083, Baia Mare, Romania.
| | - Anca Mihaly Cozmuța
- Technical University of Cluj Napoca, Department of Chemistry and Biology, Victor Babes 76, 430083, Baia Mare, Romania.
| | - Adriana Vulpoi
- Nanostructured Materials and Bio-Nano-Interfaces Center, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babes-Bolyai University, 400271, Cluj-Napoca, Romania.
| | - Lucian Barbu-Tudoran
- Babes-Bolyai University, Faculty of Biology & Geology, Clinicilor 5-7, 400006, Cluj-Napoca, Romania; NIRD of Isotopic and Molecular Technologies, 67-103 Donath, 400293, Cluj-Napoca, Romania.
| | - Klara Magyari
- Nanostructured Materials and Bio-Nano-Interfaces Center, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babes-Bolyai University, 400271, Cluj-Napoca, Romania; Institute of Environmental Science and Technology, University of Szeged, Tisza Lajos blvd. 103, 6720, Szeged, Hungary.
| | - Milica Todea
- Nanostructured Materials and Bio-Nano-Interfaces Center, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babes-Bolyai University, 400271, Cluj-Napoca, Romania; Department of Molecular Sciences, Faculty of Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Lucian Baia
- Nanostructured Materials and Bio-Nano-Interfaces Center, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babes-Bolyai University, 400271, Cluj-Napoca, Romania; Babes-Bolyai University, Faculty of Physics & Institute for Interdisciplinary Research on Bio-Nano-Sciences, M, Kogalniceanu 1, 400084, Cluj-Napoca, Romania.
| | - Flaviu Gheorghe Pop
- Surgery III, Faculty of Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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Bakthavatchalam M, Venkataraman J, Ramana RJ, Jain M, Singh B, Thanigai AK, Velyoudam V, Manickam Neethirajan S, Tiwari MK, Agarwal AK, Kalkura NS. Morphological and elemental mapping of gallstones using synchrotron microtomography and synchrotron X-ray fluorescence spectroscopy. JGH Open 2019; 3:381-387. [PMID: 31633042 PMCID: PMC6788379 DOI: 10.1002/jgh3.12171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIM Regional differences in gallstone (GS) composition are well documented in the Indian subcontinent. The reasons for the same are unknown. Etiopathogenesis of GS remains elusive despite advances in instrumentation. This was an in-depth analysis of the chemical, structural, and elemental composition of GS with special reference to synchroton studies. METHODS We used high-end sensitive analytical complementary microscopic and spectroscopic methods techniques, such as X-ray diffraction, scanning electron microscopy, Fourier transform infrared, synchrotron X-ray fluorescence spectroscopy (SR-XRF), and 2D and 3D synchrotron microtomography (SR-μCT), to study the ultra structure and trace element composition of three major types of GS (cholesterol, mixed, and pigment). SR-XRF quantified the trace elements in GS. RESULTS The cholesterol GS (monohydrate and anhydrate) were crystalline, with high calcium content. The pigment GS were amorphous, featureless, black, and fragile, with high calcium bilirubinate and carbonate salts. They had the highest concentration of iron (average 31.50 ppm) and copper (average 92.73 ppm), with bacterial inclusion. The mixed stones had features of both cholesterol and pigment GS with intermediate levels of copper (average 20.8 ppm) and iron (average 17.78 ppm). CONCLUSION SR-μCT has, for the first time, provided cross-sectional computed imaging delineating the framework of GS and mineral distribution. It provided excellent mapping of cholesterol GS. SR-XRF confirmed that pigment GS had high concentrations of copper and iron with bacterial inclusions, the latter possibly serving as a nidus to the formation of these stones.
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Affiliation(s)
| | | | | | - Mayank Jain
- Institute of GI Sciences, Gleneagles Global Hospitals and Health CityChennaiIndia
| | - Balwant Singh
- Indus 2Raja Ramanna Centre for Advance TechnologyIndoreIndia
| | - Arul K Thanigai
- Department of Physics, Energy and Biophotonics LabAMETChennaiIndia
| | | | | | - Manoj K Tiwari
- Indus 2Raja Ramanna Centre for Advance TechnologyIndoreIndia
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Parviainen A, Marchesi C, Suárez-Grau JM, Garrido CJ, Pérez-López R, Nieto JM, Cobo-Cárdenas G. Unraveling the impact of chronic exposure to metal pollution through human gallstones. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 624:1031-1040. [PMID: 29929220 DOI: 10.1016/j.scitotenv.2017.12.224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 06/08/2023]
Abstract
This study aims to explore the impact of chronic metal exposure derived from persistent pollution from mining activity using human gallstones as proxies. The samples were obtained from patients residing in geologically and environmentally contrasting areas in the Province of Huelva, SW Spain, allowing for the evaluation of the regional effect of metal pollution. The study group resides in the Iberian Pyrite Belt characterized by natural and anthropogenic metal pollution from mining activities, whereas the control group resides in the Ossa Morena Zone famous for its natural parks. A total of 68 gallstones were first classified based on their phase composition and structure and subsequently their chemical composition was studied using solution Inductively Coupled Plasma-Mass Spectrometry. The metal concentrations increased in the cholesterol-rich gallstones from pure, to mixed and composite cholesterol stones along with the increasing amount of minor phases, such as bilirubinate, carbonate, and phosphate. These cholesterol stones did not show an evident enrichment tendency. On the contrary, pigment stones, composed of bilirubinate, carbonate, and phosphate phases, were rich in a variety of elements and the regional comparison showed that the pigment stones from the study area were enriched in sulfide-associated metal(loid)s, Mn, Fe, Cu, Zn, Sr, As, Ag, Sb, and Pb with respect to the control group. Inhalation of polluted airborne particulate matter is considered as one of the main exposure routes among the residents of the study area. Additionally, consumption of local water and locally produced food products such as fruit and vegetables and dermal contact may be possible sources of exposure, but no direct connection was observed.
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Affiliation(s)
- Annika Parviainen
- Instituto Andaluz de Ciencias de la Tierra (IACT), CSIC-UGR, Avda. de las Palmeras 4, E-18100 Armilla, Granada, Spain.
| | - Claudio Marchesi
- Instituto Andaluz de Ciencias de la Tierra (IACT), CSIC-UGR, Avda. de las Palmeras 4, E-18100 Armilla, Granada, Spain; Department of Mineralogy and Petrology, University of Granada, Avda. Fuentenueva s/n, E-18002 Granada, Spain.
| | | | - Carlos J Garrido
- Instituto Andaluz de Ciencias de la Tierra (IACT), CSIC-UGR, Avda. de las Palmeras 4, E-18100 Armilla, Granada, Spain.
| | - Rafael Pérez-López
- Department of Earth Sciences, Research Center on Natural Resources, Health and the Environment, University of Huelva, Campus 'El Carmen', E-21071 Huelva, Spain.
| | - José Miguel Nieto
- Department of Earth Sciences, Research Center on Natural Resources, Health and the Environment, University of Huelva, Campus 'El Carmen', E-21071 Huelva, Spain.
| | - Gema Cobo-Cárdenas
- Riotinto Hospital, Avda. La Esquila 5, E-21660 Minas de Riotinto, Huelva, Spain
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Parviainen A, Roman-Alpiste MJ, Marchesi C, Suárez-Grau JM, Pérez-López R. New insights into the metal partitioning in different microphases of human gallstones. J Trace Elem Med Biol 2017; 44:339-348. [PMID: 28965597 DOI: 10.1016/j.jtemb.2017.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 09/15/2017] [Accepted: 09/15/2017] [Indexed: 11/22/2022]
Abstract
Chronic metal exposure, e.g. from metal mining, may cause accumulation of metals in soft and hard tissues, and in developing biomineralizations in the human body. Gallstones are biomineralizations formed in the gallbladder which are able to trap trace elements from the bile. Laser Ablation-Inductively Coupled Plasma-Mass Spectrometry (LA-ICP-MS) was used to analyze gallstone cross-sections to trace the elemental abundances and correlate them with the principal phases constituting gallstones, namely cholesterol, Ca bilirubinate salts, Ca carbonate, and Ca phosphate. Five different types of gallstones (pure, mixed, and composite cholesterol stones, pigment stone, and carbonate stone) were chosen according to a previous classification based on phase characterization by different spectroscopic and microscopic techniques. These data were combined with bulk solution ICP-MS/OES analyses for total elemental concentrations. The results indicated that cholesterol has a zero capacity to retain elements except for Ca. Hence, pure cholesterol stones contained the lowest bulk metal concentrations, and the metals were found in the scarce carbonate and phosphate phases in these calculi. Calcium and trace element concentrations increased in other types of gallstones along with increasing amount of bilirubinate, carbonates and phosphates; pigment stones being the most enriched in metals. Phosphates were the principal carriers of Ca, P, Na, Mg, Mn, Fe, Pb, and Cd, whereas carbonate phases were enriched in Ca, Mg, Na, and Mn in order of decreasing abundance. Bilirubinate on the other hand was enriched in Ca, Cu, Ag, and Ni. The higher trace metal affinities of bilirubinate and phosphate explain the elevated metal concentrations observed in the pigment stones. These results give new insight to the trace metal behavior in the gallstone formation and the metal accumulation in the human body, validating the possible use of these biomineralizations as a proxy for exposure to metal pollution.
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Affiliation(s)
- Annika Parviainen
- Instituto Andaluz de Ciencias de la Tierra (IACT), CSIC-UGR, Avda. de las Palmeras 4, E-18100, Armilla, Granada, Spain.
| | - Manuel Jesús Roman-Alpiste
- Instituto Andaluz de Ciencias de la Tierra (IACT), CSIC-UGR, Avda. de las Palmeras 4, E-18100, Armilla, Granada, Spain.
| | - Claudio Marchesi
- Instituto Andaluz de Ciencias de la Tierra (IACT), CSIC-UGR, Avda. de las Palmeras 4, E-18100, Armilla, Granada, Spain; Departamento de Mineralogía y Petrología, UGR, Avda. Fuentenueva s/n, E-18002 Granada, Spain.
| | | | - Rafael Pérez-López
- Department of Earth Sciences & Research Center on Natural Resources, Health and the Environment, University of Huelva, Campus 'El Carmen', E-21071 Huelva, Spain.
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Suvorova EI, Pantushev VV, Voloshin AE. Methods of chemical and phase composition analysis of gallstones. CRYSTALLOGR REP+ 2017. [DOI: 10.1134/s1063774517060232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Parviainen A, Suárez-Grau JM, Pérez-López R, Nieto JM, Garrido CJ, Cobo-Cárdenas G. Combined microstructural and mineralogical phase characterization of gallstones in a patient-based study in SW Spain - Implications for environmental contamination in their formation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 573:433-443. [PMID: 27572536 DOI: 10.1016/j.scitotenv.2016.08.110] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 08/16/2016] [Indexed: 06/06/2023]
Abstract
This study explores the environmental impact of metal exposure on humans through detailed phase and structural characterization of gallstones from two environmentally contrasting populations in Huelva Province (SW Spain). A total of 42 gallstone samples, obtained after surgical intervention at the Riotinto Hospital, were studied by powder X-ray diffraction (XRD), Fourier Transformed Infra-Red spectroscopy (FTIR), FTIR-μ-ATR (Attenuated Total Reflection) coupled with an optical microscope, and by Environmental Scanning Electron Microscope with Energy Dispersive X-ray Spectroscopy (ESEM-EDS), and subsequently classified according to their phase composition and structure. Additionally, the patients were enquired for their living habits in order to analyze the source of possible exposure to metal contamination. The gallstones were classified into pure, mixed and composite cholesterol stones, black and brown pigment stones, and carbonate stones. The patients from the study group residing in a region with acknowledged metal contamination of both natural and anthropogenic origin have a higher risk of metal exposure through contaminated soil, particle matter in the air, and consumption of local water and food products. According to our findings, the metal exposure is related to a higher tendency of forming black pigment stones in the study group in comparison to the control group residing in a natural park with nearly pristine environmental conditions. Moreover, the gallstones from the study group showed to contain more abundant metal components, such as Cu, Fe, Ni, and Zn, than those from the control group. To our knowledge this is the first study to examine the regional environmental impact of metal exposure on human gallstones.
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Affiliation(s)
- Annika Parviainen
- Instituto Andaluz de Ciencias de la Tierra (IACT), CSIC-UGR, Avda. de las Palmeras 4, E-18100 Armilla, Granada, Spain.
| | | | - Rafael Pérez-López
- Department of Earth Sciences, University of Huelva, Campus 'El Carmen', E-21071 Huelva, Spain.
| | - José Miguel Nieto
- Department of Earth Sciences, University of Huelva, Campus 'El Carmen', E-21071 Huelva, Spain.
| | - Carlos J Garrido
- Instituto Andaluz de Ciencias de la Tierra (IACT), CSIC-UGR, Avda. de las Palmeras 4, E-18100 Armilla, Granada, Spain.
| | - Gema Cobo-Cárdenas
- Riotinto Hospital, Avda. La Esquila 5, E-21660 Minas de Riotinto, Huelva, Spain.
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Jayanthi V, Sarika S, Varghese J, Vaithiswaran V, Sharma M, Reddy MS, Srinivasan V, Reddy GMM, Rela M, Kalkura S. Composition of gallbladder bile in healthy individuals and patients with gallstone disease from north and South India. Indian J Gastroenterol 2016; 35:347-353. [PMID: 27633032 DOI: 10.1007/s12664-016-0685-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 08/08/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Gallstones (GS) in south India (SI) are predominantly pure pigment or mixed, while in North India (NI), these are either pure cholesterol or mixed. While cholesterol rich gallbladder (GB) bile predicts cholesterol GS, constituent of bile in primary pigment GS is not known. We compared the composition of GB bile from healthy liver donors and patients with GS from north and south India. METHODS Gallbladder bile from healthy liver donors from north (10) and south India (8) served as controls. Cases were patients from north (21) and south India (17) who underwent cholecystectomy for GS disease. Gallbladder bile from both cases and controls was analyzed for cholesterol, lecithin (phospholipid), and bile salts. Gallstones were classified as cholesterol, mixed, and pigment based on morphology and biochemical analysis. RESULTS The median cholesterol concentration in control bile from north was significantly high compared to south (p<0.001) with no difference in lecithin and bile salts (p NS). Except for one sample each from north and south, the cholesterol solubility of controls was within the critical micellar zone. Mixed GS were most frequent in north India (61.9 %) while pigment GS dominated in south (61.9 %). The median cholesterol concentration in bile samples of cholecystectomy patients from north India was significantly high GS (p < 0.00001) with significant lowering of bile salts and lecithin (p < 0.00001). In south India, patients with mixed GS had high cholesterol content in bile compared to controls and patients with pigment GS; bile in latter had significantly higher concentration of bile salt compared to controls and mixed GS. The ternary plot confirmed the composition of GB bile from north and south India. CONCLUSIONS Gallbladder bile in controls and patients with GS from north India had significantly high cholesterol concentration. In south India, patients with mixed GS had cholesterol rich bile while pigment GS had higher concentrations of bile salts.
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Affiliation(s)
- V Jayanthi
- Gastroenterology and Hepatology, Institute of Gastrosciences, Global Health City, 439, Cheran Nagar, Chennai, 600 100, India.
| | - S Sarika
- Crystal Growth Center, AC Technology, University of Madras, Chepauk, Chennai, 600 005, India
| | - Joy Varghese
- Institute of Liver Disease and Liver Transplant, Global Health City, 439, Cheran Nagar, Chennai, 600 100, India
| | - V Vaithiswaran
- Gastroenterology and Hepatology, Institute of Gastrosciences, Global Health City, 439, Cheran Nagar, Chennai, 600 100, India
| | - Malay Sharma
- Jaswant Rai Specialty Hospital, Mawana Road, Meerut, 250 001, India
| | - Mettu Srinivas Reddy
- Institute of Liver Disease and Liver Transplant, Global Health City, 439, Cheran Nagar, Chennai, 600 100, India
| | - Vijaya Srinivasan
- Gastroenterology and Hepatology, Institute of Gastrosciences, Global Health City, 439, Cheran Nagar, Chennai, 600 100, India
| | - G M M Reddy
- Chettinad Hospital and Research Institute, Rajiv Gandhi Salai, OMR Chennai, Kelambakkam, Chennai, 603 103, India
| | - Mohamed Rela
- Institute of Liver Disease and Liver Transplant, Global Health City, 439, Cheran Nagar, Chennai, 600 100, India
| | - S Kalkura
- Crystal Growth Center, AC Technology, University of Madras, Chepauk, Chennai, 600 005, India
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