Effect of glycerophosphate on lithogenic bile. A new approach to treatment of cholelithiasis

Effects of chronic beta-glycerophosphate administration on growth rate and on serum, liver and bile lipid composition in the squirrel monkey--a toxicity study

Oral administration of beta-glycerophosphate lowers the lithogenic index in patients with cholesterol gallstones and is considered to have potential for dissolving them. A high dose of beta-glycerphosphate was fed to primates (Squirrel monkeys) for a period of 15 months. There were no adverse effects on body weight, hematological or liver function tests. Serum, liver and bile lipids concentrations were not significantly changed, although serum and hepatic bile phospholipids were increased. Organ weights expressed as percent of body weight were not changed except for a slight increase in kidney weight. Histological examination of liver and kidneys did not reveal any pathological findings. Slight renal hypertrophy was attributed to the sodium content of beta-glycerophosphate.

Gallstones. The present and future of medical dissolution

Adequate concentrations of bile acids and phospholipids are necessary to keep cholesterol in solution in bile. When the amount of cholesterol exceeds the capacity of bile acids and phospholipids to keep the cholesterol in micellar solution, bile becomes supersaturated; then, under appropriate conditions, cholesterol crystals form and gallstones may develop. Current dissolution therapy is aimed at desaturating the bile, thereby shifting the equilibrium of cholesterol from a crystalline phase back toward a micellar state, thus permitting gallstones to dissolve. Chenodeoxycholic acid is the drug being most extensively tested for efficacy in dissolution; at present, it is successful in about 60 per cent of cases. The primary mechanism of action appears to be suppression of biliary secretion of cholesterol. Further experience is needed to confirm the safety of chenodeoxycholic acid, to gain more precision in patient selection, and to determine ideal dose. The role of chenodeoxycholic acid in prophylaxis and in prevention of recurrence needs further study. Other potential agents for dissolution also deserve investigation.

Effects of chronic beta-glycerophosphate administration on growth rate and serum, liver and bile lipid composition in the rat--a toxicity study

The possible toxic effects of a high dose of orally administered disodium beta-glycerophosphate to the rat for a period of 33 weeks has been investigated. The studies revealed taht beta-glycerophosphate administration had no effect on either survival rat, body weight, hematological and liver function tests or on serum and liver lipids concentrations. All organ weights were similar in the control and experimental rats excepts for the kidneys which were significantly heavier in the beta-glycerophosphate-fed rats. The biliary phospholipids concentrations was significantly increased in the treated group as observed previously during short-term treatments. Histological examination of liver and kidneys did not reveal any pathological findings. These results suggest that long-term administration of beta-glycerophosphate did not induce any toxic manifestations. The observed hyperplasia of the kidneys was attributed to the effect of the sodium content of beta-glycerophosphate.

Enhancement of biliary phospholipid radioactivity by intestinal administration of labeled precursors of hepatic lecithin synthesis

An animal model is used to study the effects of different radioactive precursors of lecithin, administered intestinally, upon biliary lecithin synthesis. Choline caused greater biliary lecithin radioactivity than choline-labeled lecithin or palmitic acid. The clinical application of this finding is discussed with relation to patients with gallstones or potentially lithogenic bile. Oral administration of choline may increase biliary lecithin concentration and, thus, cholesterol-holding capacity in this patient group, thereby changing the character of the bile to a non-lithogenic state.

Gallstone dissolution in man using cholic acid and lecithin

Seven patients with radiolucent stones in the gallbladder and two patients with radiolucent stones in the biliary tree were treated with oral cholic acid and purified soya-bean lecithin for 6 months. In two patients the stones disappeared and in one patient the stones were reduced in size. In five patients fasting bile samples were obtained before and during treatment and assayed for cholesterol, bile acid, and phospholipid. In all five patients the lithogenic index of bile was reduced during treatment. The biliary deoxycholic acid concentration was increased and chenodeoxycholic acid concentration decreased during treatment.