1
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Yang B, Cao P, Bao G, Wu M, Chen W, Wu S, Luo D, Bi P. Inhibiting miRNA-146a suppresses mouse gallstone formation by regulating LXR/megalin/cubilin-media cholesterol absorption. Heliyon 2024; 10:e36679. [PMID: 39296173 PMCID: PMC11407981 DOI: 10.1016/j.heliyon.2024.e36679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 08/20/2024] [Accepted: 08/20/2024] [Indexed: 09/21/2024] Open
Abstract
Background miRNA has been implicated in regulating cholesterol homeostasis, a critical factor in gallstone formation. Here, we focused on elucidating the role of miR-146a in this pathological process. Methods C57BL/6 mice were fed with lithogenic diet (LD) and injected with miR-146 antagomir (anta-146) via the tail vein for various weeks. The gallbladders and liver tissues were collected for cholesterol crystal imaging, gallstone mass quantification, and molecular analysis. Levels of cholesterol, bile salt, phospholipids, and metabolic parameters in serum and bile were assessed by ELISA. A 3' UTR reporter gene assay was used to verify the direct target genes for miR-146. The relative expression of metabolism genes was analyzed by quantitative real-time PCR and immunoblotting. Results miR-146a-5p expression was reduced in mice and clinical samples with gallstones. Anta-146 treatment effectively prevented LD-induced gallstone formation in mice without hepatic and cholecystic damage. The mice treated with anta-146 exhibited beneficial alterations in bile cholesterol and bile acids and lipid levels in the blood. A key biliary cholesterol transporter-Megalin was identified as a direct target of miR-146. Anta-146 administration upregulated megalin expression, thereby ameliorating impaired gallbladder cholesterol absorption associated with the LXR-megalin/cubilin pathway. Conclusion The data demonstrates that miR-146 modulates gallbladder cholesterol absorption by targeting megalin, and prevents the pathogenesis of cholesterol gallstones.
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Affiliation(s)
- Bin Yang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Pingli Cao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Guoqing Bao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ming Wu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Weihong Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shuangyan Wu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ding Luo
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Pinduan Bi
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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Zhao Z, Yang Y, Wu S, Yao D. Role of Secretory Mucins in the Occurrence and Development of Cholelithiasis. Biomolecules 2024; 14:676. [PMID: 38927079 PMCID: PMC11201413 DOI: 10.3390/biom14060676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/19/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Cholelithiasis is a common biliary tract disease. However, the exact mechanism underlying gallstone formation remains unclear. Mucin plays a vital role in the nuclear formation and growth of cholesterol and pigment stones. Excessive mucin secretion can result in cholestasis and decreased gallbladder activity, further facilitating stone formation and growth. Moreover, gallstones may result in inflammation and the secretion of inflammatory factors, which can further increase mucin expression and secretion to promote the growth of gallstones. This review systematically summarises and analyses the role of mucins in gallstone occurrence and development and its related mechanisms to explore new ideas for interventions in stone formation or recurrence.
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Affiliation(s)
| | | | | | - Dianbo Yao
- Department of General Surgery, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Heping District, Shenyang 110004, China; (Z.Z.); (Y.Y.); (S.W.)
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3
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Costa CJ, Nguyen MTT, Vaziri H, Wu GY. Genetics of Gallstone Disease and Their Clinical Significance: A Narrative Review. J Clin Transl Hepatol 2024; 12:316-326. [PMID: 38426197 PMCID: PMC10899874 DOI: 10.14218/jcth.2023.00563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/16/2024] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Gallstone (GS) disease is common and arises from a combination of genetic and environmental factors. Although genetic abnormalities specifically leading to cholesterol GSs are rare, there are clinically significant gene variants associated with cholesterol GSs. In contrast, most bilirubin GSs can be attributed to genetic defects. The pathogenesis of cholesterol and bilirubin GSs differs greatly. Cholesterol GSs are notably influenced by genetic variants within the ABC protein superfamily, including ABCG8, ABCG5, ABCB4, and ABCB11, as well as genes from the apolipoprotein family such as ApoB100 and ApoE (especially the E3/E3 and E3/E4 variants), and members of the MUC family. Conversely, bilirubin GSs are associated with genetic variants in highly expressed hepatic genes, notably UGT1A1, ABCC2 (MRP2), ABCC3 (MRP3), CFTR, and MUC, alongside genetic defects linked to hemolytic anemias and conditions impacting erythropoiesis. While genetic cases constitute a small portion of GS disease, recognizing genetic predisposition is essential for proper diagnosis, treatment, and genetic counseling.
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Affiliation(s)
- Christopher J. Costa
- Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Minh Thu T. Nguyen
- Division of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT, USA
| | - Haleh Vaziri
- Division of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT, USA
| | - George Y. Wu
- Division of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT, USA
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4
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Liu W, Tu Z, Liu J, Wu T, Li D, Zhang N, Cui Y. Therapeutic effect of yinchenhao decoction on cholelithiasis via mucin in the gallbladder and intestine. Fitoterapia 2024; 172:105746. [PMID: 37967772 DOI: 10.1016/j.fitote.2023.105746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 11/07/2023] [Accepted: 11/11/2023] [Indexed: 11/17/2023]
Abstract
Cholelithiasis is a common and frequently occurring disease worldwide that belongs to the category of jaundice in traditional Chinese medicine. Yinchenhao decoction (YD) consists of Artemisia capillaris Thunb., Gardenia jasminoides J.Ellis, and Rheum palmatum L., and is traditionally used to treat jaundice, which has a significant therapeutic effect on cholelithiasis. Our study aimed to investigate the pathological mechanism of cholelithiasis and the therapeutic mechanism of YD via mucin in the gallbladder and intestine. YD was prepared and analyzed using HPLC. The supersaturation stability experiment was designed by the solvent-shift method. The cell transport experiment was conducted by coculture monolayers. The animal experiment was performed using a cholelithiasis model with a high-cholesterol diet. The related indicators were detected by automatic biochemical analyzer, PCR, western blot, or ELISA. Statistics were analyzed using χ2-tests and t-tests. As the results, in cholelithiasis, MUC5AC highly expressed in the gallbladder shortened cholesterol supersaturation and promoted cholesterol crystallization via the inflammatory cytokine signaling pathway; MUC2 highly expressed in the small intestine prolonged cholesterol supersaturation and promoted cholesterol absorption via the inflammatory cytokine signaling pathway. YD inhibited mucin expression in the gallbladder and intestine in a concentration-dependent manner for cholelithiasis treatment by inhibiting the inflammatory cytokine signaling pathway, which was attributed to the active components, including chlorogenic acid, geniposide, and rhein.
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Affiliation(s)
- Weijun Liu
- Tianjin NanKai Hospital, Tianjin Key Laboratory of Acute Abdomen Disease Associated Organ Injury and ITCWM Repair, Institute of Integrative Medicine for Acute Abdominal Diseases, No. 6 Changjiang Road, Nankai District, Tianjin 300100, China.
| | - Zhengwei Tu
- Tianjin NanKai Hospital, Tianjin Key Laboratory of Acute Abdomen Disease Associated Organ Injury and ITCWM Repair, Institute of Integrative Medicine for Acute Abdominal Diseases, No. 6 Changjiang Road, Nankai District, Tianjin 300100, China
| | - Jinjin Liu
- Tianjin NanKai Hospital, Tianjin Key Laboratory of Acute Abdomen Disease Associated Organ Injury and ITCWM Repair, Institute of Integrative Medicine for Acute Abdominal Diseases, No. 6 Changjiang Road, Nankai District, Tianjin 300100, China
| | - Teng Wu
- Tianjin NanKai Hospital, Tianjin Key Laboratory of Acute Abdomen Disease Associated Organ Injury and ITCWM Repair, Institute of Integrative Medicine for Acute Abdominal Diseases, No. 6 Changjiang Road, Nankai District, Tianjin 300100, China
| | - Donghua Li
- Tianjin NanKai Hospital, Tianjin Key Laboratory of Acute Abdomen Disease Associated Organ Injury and ITCWM Repair, Institute of Integrative Medicine for Acute Abdominal Diseases, No. 6 Changjiang Road, Nankai District, Tianjin 300100, China
| | - Nan Zhang
- Tianjin NanKai Hospital, Tianjin Key Laboratory of Acute Abdomen Disease Associated Organ Injury and ITCWM Repair, Institute of Integrative Medicine for Acute Abdominal Diseases, No. 6 Changjiang Road, Nankai District, Tianjin 300100, China.
| | - Yunfeng Cui
- Tianjin NanKai Hospital, Tianjin Key Laboratory of Acute Abdomen Disease Associated Organ Injury and ITCWM Repair, Institute of Integrative Medicine for Acute Abdominal Diseases, No. 6 Changjiang Road, Nankai District, Tianjin 300100, China.
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5
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Mo P, Chen H, Jiang X, Hu F, Zhang F, Shan G, Chen W, Li S, Li Y, Xu G. FGF15 promotes hepatic NPC1L1 degradation in lithogenic diet-fed mice. Lipids Health Dis 2022; 21:97. [PMID: 36209166 PMCID: PMC9547418 DOI: 10.1186/s12944-022-01709-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cholesterol gallstone disease (CGD) is accompanied by biliary cholesterol supersaturation. Hepatic Niemann-Pick C1-like 1 (NPC1L1), which is present in humans but not in wild-type (WT) mice, promotes hepatocyte cholesterol uptake and decreases biliary cholesterol supersaturation. In contrast, intestinal NPC1L1 promotes intestinal cholesterol absorption, increasing biliary cholesterol supersaturation. Ezetimibe (EZE) can inhibit both hepatic and intestinal NPC1L1. However, whether hepatic NPC1L1 can affect CGD progress remains unknown. METHODS Mice expressing hepatic NPC1L1 (NPC1L1hepatic-OE mice) were generated using Adeno-associated viruses (AAV) gene delivery. The protein level and function of hepatic NPC1L1 were examined under chow diet, high fat-cholesterol diet (HFCD), and lithogenic diet (LD) feeding. Gallstone formation rates were examined with or without EZE treatment. Fibroblast growth factor 15 (FGF15) treatment and inhibition of fibroblast growth factor receptor 4 (FGFR4) were applied to verify the mechanism of hepatic NPC1L1 degradation. RESULTS The HFCD-fed NPC1L1hepatic-OE mice retained the biliary cholesterol desaturation function of hepatic NPC1L1, whereas EZE treatment decreased biliary cholesterol saturation and did not cause CGD. The ubiquitination and degradation of hepatic NPC1L1 were discovered in LD-fed NPC1L1hepatic-OE mice. Treatment of FGF15 during HFCD feeding and inhibition of FGFR4 during LD feeding could affect the protein level and function of hepatic NPC1L1. CONCLUSIONS LD induces the ubiquitination and degradation of hepatic NPC1L1 via the FGF15-FGFR4 pathway. EZE may act as an effective preventative agent for CGD.
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Affiliation(s)
- Pingfan Mo
- Department of Gastroenterology, Zhejiang University School of Medicine, The First Affiliated Hospital, 79 Qingchun Road, Hangzhou, 310006, Zhejiang, China
| | - Hongtan Chen
- Department of Gastroenterology, Zhejiang University School of Medicine, The First Affiliated Hospital, 79 Qingchun Road, Hangzhou, 310006, Zhejiang, China
| | - Xin Jiang
- Department of Gastroenterology, Zhejiang University School of Medicine, The First Affiliated Hospital, 79 Qingchun Road, Hangzhou, 310006, Zhejiang, China
| | - Fengling Hu
- Department of Gastroenterology, Zhejiang University School of Medicine, The First Affiliated Hospital, 79 Qingchun Road, Hangzhou, 310006, Zhejiang, China
| | - Fenming Zhang
- Department of Gastroenterology, Zhejiang University School of Medicine, The First Affiliated Hospital, 79 Qingchun Road, Hangzhou, 310006, Zhejiang, China
| | - Guodong Shan
- Department of Gastroenterology, Zhejiang University School of Medicine, The First Affiliated Hospital, 79 Qingchun Road, Hangzhou, 310006, Zhejiang, China
| | - Wenguo Chen
- Department of Gastroenterology, Zhejiang University School of Medicine, The First Affiliated Hospital, 79 Qingchun Road, Hangzhou, 310006, Zhejiang, China
| | - Sha Li
- Department of Gastroenterology, Zhejiang University School of Medicine, The First Affiliated Hospital, 79 Qingchun Road, Hangzhou, 310006, Zhejiang, China
| | - Yiqiao Li
- Urology& Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital and Hangzhou Medical College Affiliated People's Hospital, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China.
| | - Guoqiang Xu
- Department of Gastroenterology, Zhejiang University School of Medicine, The First Affiliated Hospital, 79 Qingchun Road, Hangzhou, 310006, Zhejiang, China.
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6
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Lei YM, Yan R, Gao YD, Yang HJ, Bi HY, Duan YQ. Cholesterol crystals activate NLRP3 inflammasomes and promote gallstone formation by increasing mucin secretion. Biotech Histochem 2022; 97:546-553. [PMID: 35227133 DOI: 10.1080/10520295.2022.2036813] [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: 11/02/2022] Open
Abstract
Cholesterol crystals participate in cholesterol nucleation; however, the role of cholesterol crystals in gallstone development is unknown. Mucin secretion contributes to increased size of gallstones. Cholesterol crystals activate inflammasomes and participate in many sterile inflammation related human diseases. We investigated the role of cholesterol crystals and mucins in sterile inflammation and gallstone enlargement. We found that expression of mucin 5AC (MUC5AC), NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) and interleukin-1b (IL-1b) was increased significantly in tissues adjacent to gallstones. Experiments in vitro showed that cholesterol crystals promote MUC5AC secretion; they also increase expression of NLRP3, NLR family CARD domain-containing 4 (NLRC4), apoptosis-associated speck-like protein containing caspase recruitment domain (ASC), and cleaved caspase-1 in biliary epithelial cells. Inhibition of Inflammasomes by NLRP3, ASC or caspase-1 small interfering RNAs reduced MUC5AC secretion. Also, the IL-1 receptor antagonist, IL1RA, and caspase-1 inhibitor, Ac-YVAD, both inhibited MUC5AC secretion induced by cholesterol crystals. We found that inflammasome activation participates in cholesterol crystal induced mucin secretion and gallstone development.
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Affiliation(s)
- You-Ming Lei
- Department of Geriatric Thoracic Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ran Yan
- Emergency Center of Yunnan Province, Kunming, China
| | - Yue-Dong Gao
- Kunming Biological Diversity Regional Center of Institutions, Kunming Institution of Zoology, Chinese Academy of Science, Kunming, China
| | - Hong-Ju Yang
- Department of Geriatric Thoracic Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hong-Yan Bi
- Department of Geriatric Thoracic Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yong-Qing Duan
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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7
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Liang J, Shao W, Liu Q, Lu Q, Gu A, Jiang Z. Single Cell RNA-Sequencing Reveals a Murine Gallbladder Cell Transcriptome Atlas During the Process of Cholesterol Gallstone Formation. Front Cell Dev Biol 2021; 9:714271. [PMID: 34650971 PMCID: PMC8505819 DOI: 10.3389/fcell.2021.714271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/19/2021] [Indexed: 12/20/2022] Open
Abstract
Gallstone disease is a worldwide common disease. However, the knowledge concerning the gallbladder in the pathogenesis of cholesterol gallstone formation remains limited. In this study, using single-cell RNA sequencing (scRNA-seq) to obtain the transcriptome of gallbladder cells, we showed cellular heterogeneity and transcriptomic dynamics in murine gallbladder cells during the process of lithogenesis. Our results indicated gallbladder walls were subjected to remodeling during the process of lithogenesis. The major molecular events that happened included proliferation of epithelial cells, infiltration of immune-cells, activation of angiogenesis, and extracellular matrix modulation. Furthermore, we observed partial reversal of gallbladder cell transcriptomes by ursodeoxycholic acid treatment. This work thus provides novel and integral knowledges on the cellular changes during lithogenesis, which is of great significance to the understanding of pathogenesis and treatment of cholesterol gallstone.
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Affiliation(s)
- Jingjia Liang
- Center of Gallbladder Disease, Shanghai East Hospital, Institution of Gallstone Disease, School of Medicine, Tongji University, Shanghai, China.,Key Laboratory of Modern Toxicology of Ministry of Education, State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wentao Shao
- Center of Gallbladder Disease, Shanghai East Hospital, Institution of Gallstone Disease, School of Medicine, Tongji University, Shanghai, China.,Key Laboratory of Modern Toxicology of Ministry of Education, State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,School of Instrument Science and Engineering, Southeast University, Nanjing, China
| | - Qian Liu
- Key Laboratory of Modern Toxicology of Ministry of Education, State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qifan Lu
- Center of Gallbladder Disease, Shanghai East Hospital, Institution of Gallstone Disease, School of Medicine, Tongji University, Shanghai, China
| | - Aihua Gu
- Key Laboratory of Modern Toxicology of Ministry of Education, State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhaoyan Jiang
- Center of Gallbladder Disease, Shanghai East Hospital, Institution of Gallstone Disease, School of Medicine, Tongji University, Shanghai, China
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8
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Oh JK, Kim YR, Lee B, Choi YM, Kim SH. Prevention of Cholesterol Gallstone Formation by Lactobacillus acidophilus ATCC 43121 and Lactobacillus fermentum MF27 in Lithogenic Diet-Induced Mice. Food Sci Anim Resour 2021; 41:343-352. [PMID: 33987554 PMCID: PMC8115012 DOI: 10.5851/kosfa.2020.e93] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to evaluate the effects of Lactobacillus
acidophilus ATCC 43121 and L. fermentum MF27 on
biochemical indices in the serum, cholesterol metabolism in the liver and mucin
expression in the gallbladder in lithogenic diet (LD)-induced C57BL/6J mice to
determine the preventive effects of lactobacilli on gallstone formation. By the
end of 4 wk of the experimental period, mice fed on a LD with high-fat and
high-cholesterol exhibited higher levels of total and low-density lipoprotein
cholesterol in the serum compared to mice fed on control diet or LD with
L. acidophilus ATCC 43121 (LD+P1; p<0.05).
Cholesterol-lowering effects observed in the LD+P1 and LD with L.
fermentum MF27 (LD+P2) groups were associated with reduced
expression of 3-hydroxy-3-methylglutaryl coenzyme A reductase in the liver
compared to the LD group (p<0.05). Furthermore, expression of the
gel-forming mucin, including MUC5AB and MUC5B,
was suppressed in the LD+P1 and LD+P2 groups compared to the LD
group (p<0.05). Therefore, steady intake of both L.
acidophilus ATCC 43121 and L. fermentum MF27 may
have the ability to prevent the formation of cholesterol gallstones in
LD-induced C57BL/6J mice.
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Affiliation(s)
- Ju Kyoung Oh
- Department of Food Bioscience and Technology, Korea University, Seoul 02841, Korea
| | - You Ra Kim
- Department of Food Bioscience and Technology, Korea University, Seoul 02841, Korea
| | - Boin Lee
- Department of Animal Sciences and Biotechnology, Kyungpook National University, Sangju 37224, Korea
| | - Young Min Choi
- Department of Animal Sciences and Biotechnology, Kyungpook National University, Sangju 37224, Korea
| | - Sae Hun Kim
- Department of Food Bioscience and Technology, Korea University, Seoul 02841, Korea
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9
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Eze CU, Ezugwu EE, Ohagwu CC. Prevalence of Cholelithiasis Among Igbo Adult Subjects in Nnewi, Southeast Nigeria. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2017. [DOI: 10.1177/8756479316680998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Aim: To determine the prevalence of cholelithiasis in a Nigerian population. Subjects and Methods: A cross-sectional study of Igbo adult subjects in Nnewi, Nigeria, was conducted from June 2011 to April 2014. A sample of 3501 adult subjects’ gallbladders and associated biliary systems was evaluated by sonography, and the presence or absence of cholelithiasis was documented. The age and anthropometric variables of the subjects were recorded. Results: The subjects (18-92 years) comprised 1731 men (49.4%) and 1770 women (50.6%). Only 4.4% (n = 154) had cholelithiasis. It is more common in women than men, at a ratio of 2.8:1. It is also more common in subjects with a high body mass index. Conclusion: The prevalence of cholelithiasis among the Igbo people in Nnewi is 4.40%, and it is about three times more common in women than men.
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Affiliation(s)
- Charles Ugwoke Eze
- Department of Medical Radiography and Radiological Sciences, Faculty of Health Science and Technology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Emmanuel Emeka Ezugwu
- Department of Radiography and Radiological Sciences, Faculty of Health Science and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Christopher Chukwuemeka Ohagwu
- Department of Radiography and Radiological Sciences, Faculty of Health Science and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
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Chen Y, Kong J, Wu S. Cholesterol gallstone disease: focusing on the role of gallbladder. J Transl Med 2015; 95:124-31. [PMID: 25502177 DOI: 10.1038/labinvest.2014.140] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/11/2014] [Accepted: 10/15/2014] [Indexed: 02/06/2023] Open
Abstract
Gallstone disease (GSD) is one of the most common biliary tract diseases worldwide in which both genetic and environmental factors have roles in its pathogenesis. Biliary cholesterol supersaturation from metabolic defects in the liver is traditionally seen as the main pathogenic factor. Recently, there have been renewed investigative interests in the downstream events that occur in gallbladder lithogenesis. This article focuses on the role of the gallbladder in the pathogenesis of cholesterol GSD (CGD). Various conditions affecting the crystallization process are discussed, such as gallbladder motility, concentrating function, lipid transport, and an imbalance between pro-nucleating and nucleation inhibiting proteins.
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Affiliation(s)
- Yongsheng Chen
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Kong
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shuodong Wu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
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11
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Abstract
Gallstone disease (GSD) is one of the most common biliary tract disorders worldwide. The prevalence, however, varies from 5.9-21.9% in Western society to 3.1-10.7% in Asia. Most gallstones (75%) are silent. Approximately half of symptomatic gallstone carriers experience a second episode of biliary pain within 1 year. These individuals are at increased risk of developing acute cholecystitis, acute cholangitis, and biliary pancreatitis. As can be expected, these complications burden health care systems because of their invasive nature and surgical cost. Factors that contribute to gallstone formation include supersaturation of cholesterol in bile, gallbladder hypomotility, destabilization of bile by kinetic protein factors, and abnormal mucins. Epidemiologic studies have implicated multiple environmental factors and some common genetic elements in gallstone formation. Genetic factors that influence gallstone formation have been elaborated from linkage studies of twins, families, and ethnicities. Accumulating evidence suggests that genetic factors play a role in GSD.
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Affiliation(s)
- Shih-Chang Chuang
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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12
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Chuang SC, Hsi E, Lee KT. Mucin genes in gallstone disease. Clin Chim Acta 2012; 413:1466-71. [PMID: 22705400 DOI: 10.1016/j.cca.2012.06.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 06/04/2012] [Accepted: 06/07/2012] [Indexed: 01/27/2023]
Abstract
Gallstone disease is a complex disorder that can be caused by environmental influences, common genetic factors and their interactions. Three major pathogenic abnormalities are considered to involve in gallstone formation: cholesterol supersaturation in bile, precipitation and nucleation of excess cholesterol, and gallbladder hypomotility, while, mucin takes part in the cholesterol nucleation process. Up to date, more than 20 mucin genes have been reported, 9 of them are identified at the mRNA and/or protein level in native gallbladder and its associated diseases. In the gallbladder, mucin is essential for best protection against detergent effect of high concentration of bile acids. Over the past decade, the properties, expressions and functions of the gallbladder mucins are delineated in animal and human studies. Alteration expressions of mucins are thought to response during the pathogenesis of gallstone formation. Moreover, recent genetic association study demonstrated mucin gene polymorphisms may also influence susceptibility to gallstone disease. This review is not to provide a complete coverage of all the aspects of mucin glycoproteins, but focus on the role and expression of mucins involve in the regulation of cholelithogenesis.
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Affiliation(s)
- Shih-Chang Chuang
- Department of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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13
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Zhang Y, Liu W, Zhou J, Wang W, Wang RP, Ma XF, Wang Y. Clinical epidemiological characteristics and correlative factors of polypoid lesions of the gallbladder. Shijie Huaren Xiaohua Zazhi 2011; 19:3081-3087. [DOI: 10.11569/wcjd.v19.i29.3081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the clinical epidemiological characteristics and correlative factors of polypoid lesions of the gallbladder (PLG) in Qingdao, China.
METHODS: A total of 27 400 people who underwent health examination from January 2009 to December 2009 at our hospital were included in the study. Stratified random sampling was adopted to select 1 678 patients who were diagnosed with PLG by ultrasound to conduct an epidemiological survey, and 1 700 people without PLG were used as controls. Multifactor unconditional Logistic regression analyses were performed to investigate the relationship of life styles, behavior factors, blood sugar (FPG), triglycerides (TG), total cholesterol (CHO), fatty liver, cholecystitis and gallbladder stone with PLG. The clinical pathological characteristics and rationality of cholecystectomy were analyzed in 219 patients who had PLG with a diameter of >10 mm and underwent cholecystectomy.
RESULTS: Of 2 7400 people, 27 301 (99.64%) had complete data. The prevalence of PLG was 6.15% (1 678/27 301). The male to female ratio was 1.5:1. The majority (64.96%) of patients ranged in age between 30 and 59 years. Solitary PLG and multiple PLG accounted for 37.72% and 62.28%, respectively. The majority (86.95%) of PLG were smaller than 10 mm in diameter. Cholesterol polyps (CPs), benign non-CPs and malignant gallbladder diseases accounted for 79.14%, 17.76% and 3.10%, respectively. Multifactor unconditional Logistic regression analyses revealed that life styles, behavior factors, TG, FPG, and gallbladder stone had no significant association with PLG (all P > 0.05), while age, sex, CHO, fatty liver, and cholecystitis were significantly correlated with PLG (all P < 0.05). Of 219 (13.05%) patients who had PLG with a diameter of >10 mm and underwent cholecystectomy, 76.26% had benign PLG and 23.74% had malignant disease.
CONCLUSION: The incidence of PLG was 6.15% in Qingdao. Abnormal CHO metabolism, fatty liver and cholecystitis were correlative factors for PLG. Cholecystectomy should be cautiously selected in patients who had PLG with a diameter ≤10 mm.
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Effect of Escherichia coliform on the biomineralization of calcium bilirubinate in mimic systems. Colloids Surf B Biointerfaces 2008; 65:11-7. [DOI: 10.1016/j.colsurfb.2008.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Revised: 01/11/2008] [Accepted: 02/12/2008] [Indexed: 11/18/2022]
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Kim HJ, Kim SH, Chae GB, Lee SJ, Kang CD. Increased expression of mucin 5AC mRNA and decreased expression of epidermal growth-factor receptor mRNA in gallstone patients. TOHOKU J EXP MED 2008; 214:139-44. [PMID: 18285671 DOI: 10.1620/tjem.214.139] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Mucin, a major component of mucus, plays an important role in gallstone formation. The molecular mechanisms of mucin overproduction, however, still remain unknown. Several mucin genes (MUC) have been implicated in various diseases and gel-forming mucin genes (MUC2, MUC5AC, MUC5B, and MUC6) were recognized to be the important components of digestive mucus. Furthermore epidermal growth factor receptor (EGFR) might regulate the function of MUC5AC. The aim of this study was to investigate the expression of MUC5AC mRNA and the possible role of EGFR in the function of MUC5AC. Total twelve patients underwent elective laparoscopic cholecystectomy due to gallstone disease were enrolled (age: 64.6 +/- 15.5 years). The control group included two patients who underwent cholecystectomy without stone. The expression levels of MUC5AC and EGFR mRNAs were analyzed in gallbladder tissues using real-time reverse transcription-polymerase chain reaction assay. The expression levels of MUC5AC mRNA were increased in gallstone patients compared with those in control subjects, ranging from 2.5 to 1558 folds (mean 512.8 +/- 493.6 folds, p = 0.004). In contrast, the expression levels of EGFR mRNA were decreased in all patients (mean 0.378 +/- 0.322 fold, p = 0.002), and negative correlation was found between MUC5AC and EGFR (p = 0.02). There was no significant difference according to age, body mass index, and stone composition in the expression levels of MUC5AC and EGFR mRNAs. In conclusion, MUC5AC is over-expressed in gallstone disease, despite the decrease in the expression of EGFR mRNA. MUC5AC may be related to mucus hypersecretion.
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Affiliation(s)
- Hyo Jung Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
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Sayers C, Wyatt J, Soloway RD, Taylor DR, Stringer MD. Gallbladder mucin production and calcium carbonate gallstones in children. Pediatr Surg Int 2007; 23:219-23. [PMID: 17225180 DOI: 10.1007/s00383-006-1867-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2006] [Indexed: 10/23/2022]
Abstract
In contrast to adults, calcium carbonate gallstones are relatively common in children. Their pathogenesis is poorly understood. Cystic duct obstruction promotes calcium carbonate formation in bile and increases gallbladder mucin production. We tested the hypothesis that mucin producing epithelial cells would be increased in gallbladders of children with calcium carbonate gallstones. Archival gallbladder specimens from 20 consecutive children who had undergone elective cholecystectomy for cholelithiasis were examined. In each case, gallstone composition was determined by Fourier transform infrared microspectroscopy. Gallbladder specimens from six children who had undergone cholecystectomy for conditions other than cholelithiasis during the same period were used as controls. Multiple sections were examined in a blinded fashion and scored semiquantitatively for mucin production using two stains (alcian blue and periodic acid-Schiff). Increased mucin staining was observed in 50% or more epithelial cells in five gallbladder specimens from seven children with calcium carbonate stones, compared to 5 of 13 with other stone types (P = 0.17) and none of the control gallbladders (P = 0.02). Gallbladders containing calcium carbonate stones were significantly more likely than those containing other stone types or controls to contain epithelial cells with the greatest mucin content (P = 0.03). Gallbladders containing calcium carbonate stones were also more likely to show the ulcer-associated cell lineage. These results demonstrate an increase in mucin producing epithelial cells in gallbladders from children containing calcium carbonate stones. This supports the hypothesis that cystic duct obstruction leading to increased gallbladder mucin production may play a role in the development of calcium carbonate gallstones in children.
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Affiliation(s)
- Craig Sayers
- Department of Histopathology, St James's University Hospital, Leeds, UK
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Xie A, Shen Y, Chen C, Han C, Tang Y, Zhang L. Glycoprotein adsorption into bilirubin/cholesterol mixed monolayers at the air-water interface. COLLOID JOURNAL 2006. [DOI: 10.1134/s1061933x06030203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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