Composition of gallbladder bile in healthy individuals and patients with gallstone disease from north and South India

Bile acid signaling in the regulation of whole body metabolic and immunological homeostasis

Bile acids (BAs) play a crucial role in nutrient absorption and act as key regulators of lipid and glucose metabolism and immune homeostasis. Through the enterohepatic circulation, BAs are synthesized, metabolized, and reabsorbed, with a portion entering the vascular circulation and distributing systemically. This allows BAs to interact with receptors in all major organs, leading to organ-organ interactions that regulate both local and global metabolic processes, as well as the immune system. This review focuses on the whole-body effects of BA-mediated metabolic and immunological regulation, including in the brain, heart, liver, intestine, eyes, skin, adipose tissue, and muscle. Targeting BA synthesis and receptor signaling is a promising strategy for the development of novel therapies for various diseases throughout the body.

Microstructural and heavy metal analysis of gallstones prevalent in Jharkhand and its implications in the treatment

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.

Morphological and elemental mapping of gallstones using synchrotron microtomography and synchrotron X-ray fluorescence spectroscopy

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.

Microstructural diversity of gallstones revealed by spectral microanalyses and their association with hepatic parameters

BACKGROUND

Gallstones (GS) are formed as a result of impaired metabolic regulation and can be reflected in serum parameters. This study was focused on classifying GS based on spectral microanalysis and identifying the possible role of serum hepatic parameters on GS of different compositions.

METHODS

The study included a total of 126 GS from 80 consecutive patients who underwent cholecystectomy for GS diseases in a single center. The composition and microstructure of GS were analyzed using Fourier-transform infrared (FTIR) spectroscopy, field emission scanning electron microscopy (FESEM), and energy dispersive X-ray spectroscopy (EDS). The serum hepatic parameters were studied in order to establish a possible etiologic relationship with GS composition.

RESULTS

In the study group, the incidence of GS was higher in females 62 (77.5%) compared with males 18 (22.5%). The mean age was 42.81 ± 13.01 and 43.78 ± 14.4 years for female and male patients, respectively. Based on composition, the GS were assigned to four major groups: cholesterol, pigment, phosphate, and mixed stones. Mixed composition stones totally represented the majority 53 (66.3%), followed by pure cholesterol 23 (28.8%), pigment stones 2 (2.5%), and phosphate stones 2 (2.5%), respectively. Elemental composition revealed the presence of carbon (C), oxygen (O), calcium (Ca), and phosphorus (P) to be major elements along with traces of sodium (Na), magnesium (Mg), aluminum (Al), iron (Fe), copper (Cu), bromine (Br), manganese (Mn), and zinc (Zn). Among serum parameters, total bilirubin, direct bilirubin, indirect bilirubin, serum glutamic-oxaloacetic transaminase, and total protein were higher in patients with pigment GS than cholesterol GS.

CONCLUSIONS

Characterization of GS indicates that different types of stones have different characteristics in terms of microstructure, elemental composition, and distribution. Serum hepatic function test profiles showed an association with the compositions of GS.