P–258 Ubiquitin, in the human embryo secretome, is a biomarker for embryo viability: a potential predictor of live-births, post embryo transfer

Study question

Whether embryo-secreted ubiquitin could serve as a predictive biomarker for embryo development and viability for assessing pregnancy outcome?

Summary answer

Embryo-secreted ubiquitin concentrations showed positive correlations with (a) developing embryonic stages, (b) implantation rates, (iii) live-birth rates. Their altered levels were associated with miscarriages.

What is known already

Human infertility affects 15–20% couple and is mitigated by ART approaches. Poor biological-viability of in vitro developed embryos contributes to implantation failure and low birth rates(LBR). The current morphology-based embryo selection approach has shortcomings in identifying biologically-viable embryos capable of producing live-births. Earlier studies have identified ubiquitin as a biomarker for embryo developmental competence. However, there have been no studies on estimations of ubiquitin in embryo-spent medium samples (E-SMs) and their correlative analysis with embryo-quality score and pregnancy outcome. Hence, such studies are required to establish whether or not ubiquitin could be a biomarker predicting pregnancy outcome.

Study design, size, duration

This was a retrospective, multi-centric study performed between July 2018 and September 2020. A total of 574 E-SMs (from 574 individual embryos), from 325 infertile women, were analysed for ubiquitin levels. Frozen E-SMs post-thaw were subjected to sandwich ELISA (Mybiosource, USA). Correlation analysis was performed on ubiquitin levels with developing embryonic stages and their scores, implantation rates (IRs) and pregnancy outcomes in terms of LBR.

Participants/materials, setting, methods

We measured ubiquitin levels in E-SMs obtained from three embryonic stages i.e., cleavage-stage (2–10-cells; n = 182), morulae (n = 102) and blastocysts (n = 290). Ubiquitin concentrations among three developmental stages were compared and analysed using the Student’s t-test/ANOVA (P ≤ 0.05), followed by Tukey posthoc test. Levels of ubiquitin were correlated (using Pearson/Spearman analysis) with (a) developing embryonic stages, (b) embryo morphology, (c) IRs, and (d) pregnancy outcomes in terms of LBR.

Main results and the role of chance

Of 574 E-SMs analysed, 540 (94.07%) had detectable ubiquitin levels (pg/ml) and they varied in an increasing manner across developing embryonic stages and, across the three clinics. We observed a significantly different (p < 0.0001) levels of ubiquitin in three sets of secretors i.e low (153.1 ± 5.4; n = 219), medium (498.9 ± 15.7) & high (1615 ± 46.5) secretors. Levels of ubiquitin among three developmental stages were significantly (p < 0.05) different under FET, but not with fresh-ET categories. Ubiquitin levels were independent of cleavage-stage morphology score but showed a positive correlation with blastocyst grades. Also, we observed a significant (p < 0.05) positive correlation of ubiquitin levels with implantation rates. Importantly, ubiquitin levels were higher in E-SMs of embryos which gave live-births vis-à-vis those with no-births. Moreover, altered levels (very high low) were associated with those embryos which resulted in miscarriages. This is the first report which measured ubiquitin in individual hE-SMs from three developing embryos and showed a development stage-wise positive correlations as well as a significant association (p < 0.0001) of ubiquitin levels with implantation and live-birth rates.

Limitations, reasons for caution

Observed variations in levels of ubiquitin across clinics could be attributed to (i) oocyte/sperm donors’ variation and their infertility status (i) IVF-ET protocol differences. A large multi-centric cohort studies are required to establish the predictive value of ubiquitin for assessing embryo-viability and pregnancy outcome in term of live-births.

Wider implications of the findings: For the first time, our multi-centric study showed developmental stage-specific changes in ubiquitin levels. It could be a valuable biomarker of embryo-viability and to predict IR and live-births. Ubiquitin, as a biomarker, could be a valuable adjunct to currently practicing embryo score system for selecting transferable quality embryos.

Trial registration number

Not applicable

P–172 Data-independent acquisition-proteomics of human embryo-spent medium and identification of potential embryo biomarkers

Study question

Can human embryo-derived protein(s) serve as viability biomarkers to predict pregnancy outcome, post embryo transfer?

Summary answer

The human embryo-spent medium proteome, using data-independent acquisition (DIA) approach, could identify novel biomarkers for use in elective embryo transfer.

What is known already

Morphological assessment is used for elective embryo transfer. To improve IVF outcomes and to avoid multiple gestations, embryo-viability assessment is required toward single embryo transfer. Embryo proteomics could provide a non-invasive approach to assess embryo viability. With the advent of DIA mode proteomics, a robust proteome of E-SM could be determined.

Study design, size, duration

This was a retrospective study performed between May and December, 2020 using ten E-SMs obtained from ten individual transferable-quality embryos. Frozen E-SMs, following post-thaw, were subjected to LC-MS-MS analysis. Identified proteome profiles were being potentially correlated to embryo quality scores and pregnancy outcomes in terms of live births.

Participants/materials, setting, methods

The E-SMs were processed for proteomic analysis and subjected to reduction, alkylation and trypsin digestion. Trypsin digested samples were desalted followed by LC-MS/MS using DIA method. Obtained results were searched against human peptide spectral library using Skyline. Differentially expressed proteins were identified by MSStat. Individual peptide peak area under the curve was normalized and analyzed using Student t-test. Fold change was calculated to identify differentially regulated proteins in blank and E-SM samples.

Main results and the role of chance

Using a high-resolution mass spectrometer and high throughput DIA method, we identified 5,502 peptides corresponding to 3,396 proteins from blank and E-SM samples, derived from five non-transferred embryos. We observed that 516 proteins were specific to E-SMs vies-a-vies those of embryo-free blank medium. Statistical analysis showed that 25 proteins were significantly present E-SMs vs. blank. Interestingly, we observed that 16 proteins were down regulated and 9 were up regulated in E-SMs vs. blank medium. Furthermore, E-SMs, from transferred embryos, contained 2,467 peptides corresponding to 1,741 proteins; of these, 1, 689 proteins were specific to E-SMs with 60 (58 down regulated and 2 up regulated) of them being significantly expressed in E-SMs vis-à-vis embryo-free blank medium. Considering the available met analysis published data, our study is the first to use DIA acquisition for high-throughput analysis of human embryo proteome and identification of biomarkers of embryo viability and for possible prediction of pregnancy outcome.

Limitations, reasons for caution

Proteins, other than HAS, detected in the blank medium could be because of non-purified HAS or undeclared proteins and DIA approach used. A large cohort study and meta-analysis using DIA mode are required to establish the embryo-proteome having predictive potential for embryo biological viability.

Wider implications of the findings: For the first time, using DIA mode, a global embryo proteome assessment could be made, establishing a novel embryo viability biomarkers. This, along with the morphological analysis, could be practiced for selection of transferable quality embryo(s)

Trial registration number

Not applicable

Endometrial polyps associated with endometrial hyperplasia in an obese bonnet monkey (Macaca radiata): a case report

BACKGROUND

A 10-year-old, female bonnet monkey (Macaca radiata) showed abnormal menstrual cycle length with heavy menstrual bleeding for 6-8 days.

METHODS

Uterine ultrasound and histological examinations of endometrium by endometrial biopsy.

RESULTS

An ultrasound examination of the uterine cavity showed presence of an enlarged polypoid mass. Further endometrial histology confirmed the presence of simple endometrial hyperplasia.

CONCLUSIONS

We report for the first time that endometrial polyp is associated with endometrial hyperplasia in obese bonnet monkey.

Accelerated fractionated radiation by concomitant boost (AFX-CB) with concurrent cis-platinum (CDDP) for advanced nasopharyngeal carcinoma

5540

Background: Recent data (RTOG 90–03 and RTOG 99–14) strongly suggest that concomitant boost radiation (AFX-CB) and concurrent chemoradiation offer a local control advantage in advanced head and neck cancer patients. Based on our previous experience treating unresectable head and neck cancer, we initiated a phase II trial delivering CDDP concurrent with AFX-CB for advanced nasopharyngeal carcinoma (NPC). Methods: From 2/99–7/05, 44 patients with newly diagnosed stage IIa-IV NPC were treated with AFX-CB to 70Gy/6 weeks (BID RT last 2 weeks with a 3D-conformal plan, 6 hr interfraction interval) with 2–3 cycles of concurrent CDDP (100mg/m2) on day 1, 22, 43 of radiation followed by adjuvant 5-Fluorouracil/CDDP. The median age was 46 (24 to 83) and 20 patients were male. Disease characteristics were as follows: 1997 AJCC stage: II-7; III-14 and IV-23, T3/T4 66%, N2/N3 55%. Results: With a median follow-up of 30 mo. (3–78 mo.), the crude local control rate (LC) was 93%, regional control (RC) was 98%, locoregional control (LRC) 91%, freedom from distant metastasis (FFDM) was 86%, disease-free survival (DFS) was 82%, and overall survival (OS) was 89%. Eighty-six percent of patients were able to receive 2–3 cycles of adjuvant chemotherapy. Four of the 6 distant metastases occurred after 3 years post-treatment. One of the 3 local failures was salvaged with additional chemoradiation and is without evidence of recurrence 23 months later. Thus, the total crude local control is 95%. Among 29 T3/T4 patients, local control was 93%. For all patients, the three year actuarial LC, RC, LRC, FFDM, DFS and OS were 95%, 98%, 93%, 94%, 86% and 87%, respectively. Major grade 3 acute toxicities include mucositis (59%), dysphagia (41%), vomiting (20%) and anemia (4.5%). Average hemoglobin drop was 2.3 gm (17.7%). Ninety percent of patients received erythropoietin support and near 20% required blood transfusion. Late toxicities included grade 3 tinnitus in 1, grade 2 serous otitis in 1, osteoradionecrosis in 1 and brain necrosis in 2. Conclusions: AFX-CB with concurrent and adjuvant chemotherapy for advanced NPC provides excellent locoregional control and acceptable toxicity. Future efforts will focus on decreasing toxicity and increasing systemic control.

No significant financial relationships to disclose.

Ontogeny and cellular localization of SRY transcripts in the human testes and its detection in spermatozoa

The sex-determining region on the Y (SRY) gene is unequivocally designated as the testis-determining factor in mammals; however, its roles beyond sex determination, if any, have been hitherto unknown. To determine whether SRY has any roles beyond sex determination, herein the expression of SRY mRNA was investigated in the midtrimester human fetal, infantile and adult testes as well as in ejaculated spermatozoa. High levels of SRY transcripts were in situ localized to the Sertoli cells of the developing testis at 9 weeks of gestation, and the expression persisted at comparable levels throughout the midtrimester (until 22 weeks) and also in the testis of an infant at 3 months of age. The germ cells and other somatic cells in the testes of fetuses and the infant were negative for SRY expression. The mRNA for SRY was detected in the spermatogenic cells, particularly the spermatogonia and the round spermatids; the expression was negligible in the meiotic stages. A single transcript of approximately 1.2 kb was detected in the adult testes and isolated spermatogonial cells. In the adult testis, in situ hybridization (ISH) studies revealed a switch in the cellular localization of SRY transcripts. SRY transcripts were also demonstrable by RT-PCR of RNA from ejaculated human spermatozoa. ISH revealed the presence of SRY transcripts in the midpiece of 50% of ejaculated sperm. These results suggest that SRY may have extensive roles in male reproductive physiology, such as maturation of fetal testis, spermatogenesis, sperm maturation and early embryonic development.

Rab coupling protein (RCP): a novel target of progesterone action in primate endometrium

Acquisition of functional receptivity by the endometrium is assumed to be effected by progesterone-dependent expression and repression of several genes during the implantation window in a menstrual cycle. In the present study, we employed differential display (DD) reverse transcription-polymerase chain reaction (RT-PCR) to identify progesterone-dependent gene/gene fragments that are differentially expressed during the peri-implantation phase in receptive and nonreceptive endometria, obtained from fertile and infertile bonnet monkeys respectively. Receptive endometria were obtained from regularly cycling (n=5) fertile female bonnet monkeys. Endometrial nonreceptivity was induced by treating bonnet monkeys with either 2.5 mg (n=5) or 5.0 mg (n=5) onapristone (ZK 98.299), an antiprogestin, on every third day for one cycle. Ovulation, levels of circulatory hormones (estradiol and progesterone) and menstrual cycle length did not change in treated animals; however, endometrial growth was retarded. DD2, one of the differentially expressed cDNA fragments, showed higher representation in nonreceptive endometria than in receptive endometria. The DD2 sequence was found to be homologous to the sequence of the carboxyl terminal region of Rab coupling protein (RCP), a recently discovered protein involved in intracellular vesicular trafficking. To confirm the identity of DD2 as RCP, RT-PCR studies were carried out with a forward primer deduced from the RCP sequence and a reverse primer from the DD2 sequence. The product (DDRCP) obtained, when sequenced, revealed 95% homology with the nucleotide number 1196-1757 of human RCP cDNA. Furthermore, the pattern of DDRCP expression at transcript level was found to be similar to that shown by DD2; that is, it was higher in nonreceptive endometrium. Northern analysis using labeled DD2 or DDRCP cDNA fragments identified two transcripts of 6.0 and 4.0 kb in human endometrium. In situ hybridization studies using digoxigenin-labeled DD2 revealed significantly higher (P < 0.05) localization of endometrial RCP transcripts in the proliferative phase than in the peri-implantation phase in control animals. The localization was also significantly (P < 0.01) higher in peri-implantation-phase endometria from antiprogestin-treated animals than in control animals. These antiprogestin-treated animals, however, did not demonstrate any concomitant increase in the levels of immunoreactive endometrial Rab4 and Rab11 during the peri-implantation phase. A similar pattern of cycle-dependent RCP expression was observed in human endometrial biopsies. Furthermore, significantly higher (P < 0.05) levels of RCP transcripts were detected during the peri-implantation phase in women with unexplained infertility (n=3) than in fertile women (n=3). This is the first report indicating the endometrial expression of RCP and its hormonal regulation.

Expression profiles of endometrial leukemia inhibitory factor, transforming growth factor beta2 (TGFbeta2), and TGFbeta2 receptor in infertile bonnet monkeys

The expression profiles of leukemia inhibitory factor (LIF), transforming growth factor beta2 (TGFbeta2), and transforming growth factor beta2 receptor (TGFbeta2R) were analyzed during the peri-implantation period in regularly menstruating, fertile bonnet monkeys and in animals in which endometrial nonreceptivity was induced by administering an antiprogestin, onapristone. Based on our previous experiences, a dose of 2.5 or 5 mg of onapristone was administered s.c. every third day during the menstrual cycle, because these dosages impair endometrial development without upsetting the normal gonadal endocrine profiles. Endometrial biopsy specimens were collected during the proliferative phase (estradiol levels about 200 pg/ml, n = 5) and peri-implantation period (Day 8 after midcycle peak in estradiol levels, n = 5) from normal ovulatory animals and during the peri-implantation period from onapristone-treated animals (n = 10). The biopsy specimens were processed to determine the expression patterns of LIF, TGFbeta2, and TGFbeta2R by immunohistochemical and reverse transcription-polymerase chain reaction (RT-PCR) methods. Levels of both protein and mRNA for LIF, TGFbeta2, and TGFbeta2R (analyzed by immunohistochemistry and RT-PCR, respectively) were greater in the endometrial samples collected during the peri-implantation period compared to samples collected during the proliferative phase in control animals. Treatment with either of the two doses (2.5 or 5 mg) of onapristone caused a significant (P < 0.05) down-regulation in the expression of LIF in the peri-implantation endometria. The endometrial expressions of TGFbeta2 and TGFbeta2R mRNAs were reduced significantly in animals treated with 5 mg of onapristone, but not in those treated with the lower dose. However, immunoreactive TGFbeta2 and TGFbeta2R proteins were significantly (P < 0.05) down-regulated in the endometrial samples from both the 2.5- and 5-mg-treated groups. The alterations observed in the expression patterns of LIF, TGFbeta2, and TGFbeta2R were specific, because the expression levels of epidermal growth factor receptor remained unaffected in the endometria from the treated groups. The present study demonstrates derangement in the expression profiles of LIF, TGFbeta2, and TGFbeta2R during the peri-implantation period in infertile bonnet monkeys. It may be hypothesized that TGFbeta2 function is one of the early steps in the regulation of the progesterone-driven cascade of events leading to endometrial receptivity, and that any aberration in this step may adversely affect the subsequent molecular events (i.e., expression of LIF). These data also suggest that potential aberrations in the functional network of locally produced cytokines and growth factors even may occur in an endometrium exposed to the optimal peripheral hormonal levels.

Endometrial contraception: modulation of molecular determinants of uterine receptivity

Modulation of endometrial receptivity is a promising approach for fertility regulation since it allows a contraceptive to act specifically at the endometrium. This was corroborated by our previous observations that treatment with low doses of a pure progesterone antagonist (PA, antiprogestin), onapristone (ZK 98299), in bonnet monkeys inhibited fertility by selectively retarding endometrial development, without affecting the hypophyseal-hypothalamic function. In the present study, further investigations, undertaken to analyze the molecular repertoire of a nonreceptive primate endometrium, determined expression of: steroid hormone receptors, i.e. progesterone receptor (PR) and estrogen receptor (ER); cytokines, i.e. leukemia inhibitory factor (LIF): transforming growth factor beta (TGFbeta) and its receptor (TGFbetaR); and cell adhesion molecules, i.e. integrins (alpha(v)beta(3), alpha(1)beta(1)). These studies were conducted during the different phases of the normal menstrual cycle and following treatment with different doses of onapristone (2.5 mg, 5 mg, or 10 mg every third day for one cycle) in bonnet monkeys. The molecules were analysed collectively to explore the possibility of a correlation between expression of these markers and endometrial receptivity and to investigate whether there exists a regulatory link between expression of these molecules under in vivo conditions. Three types of expression patterns of endometrial factors were observed during the peri-implantation period following onapristone treatment: 1) LIF, alpha(v)beta(3), and alpha(1)beta(1) showed significant (P < 0.02) down regulation in glandular epithelium of endometria in animals treated with all three doses of onapristone as compared to the control group. This was indicative of their critical role in the progesterone-driven cascade leading to implantation. 2) PR, TGFbeta, and TGFbetaR remained unaffected in the endometria from 2.5 mg treated animals and showed down regulation in animals treated with 5 and 10 mg onapristone as compared to the control group, thereby suggesting that the expression of these markers may not truely reflect endometrial receptivity per se. However, their facilitatory role in preparing the endometrium for implantation can not be ruled out since continued perturbation in the expression of these molecules may affect endometrial growth, remodelling, and differentiation, which in turn may render the endometrium nonreceptive; 3) ER remained unaltered in endometria of animals rendered infertile with 2.5, 5, and 10 mg onapristone. This observation indirectly suggests that onapristone-induced endometrial changes are mediated via some specific mechanisms. The present study clearly demonstrates that endometrial non-receptivity induced at low doses of onapristone is associated with changes in the expression pattern of specific molecular markers. However, no direct correlation was observed between in vivo expression of TGFbeta, LIF, and integrins, thereby lending support to the concept that there exists redundancy or multiple pathways which regulate implantation events.

Detection of progesterone receptor transcript in human spermatozoa

The present study, to our knowledge, is the first to demonstrate presence of progesterone receptor (PR) transcript in human spermatozoa. The study shows the presence of low copy number PR mRNA in mature human spermatozoa. The PR transcript in spermatozoa was detected by reverse transcriptase-polymerase chain reaction using primers specific for the hormone binding domain and the DNA binding domain of the conventional uterine PR. Further, the cDNA sequence of the partial PR transcript from spermatozoa was found to be identical to the region spanning nucleotides 2694 to 3230 of the conventional PR full-length cDNA sequence. This study also indirectly suggests that the PR protein indeed is an intrinsic sperm protein and is not acquired through proteinaceous secretions of accessory reproductive organs.

Lymphoproliferative responses of leprosy patients and healthy controls to nitrocellulose-bound M. leprae antigens

The lymphoproliferative responses of 51 leprosy patients and 11 healthy contacts were analyzed using the nitrocellulose-bound specific antigen fractions from the cell-free extract of Mycobacterium leprae. The main proliferation-inducing fraction for peripheral blood mononuclear cells of the healthy contacts was found to be the Fraction II, bearing antigens in the range of 66-45 kDa. However, this fraction failed to induce lymphoproliferation in the leprosy patients, unlike healthy contacts (p < 0.032). The number of responders as well as the strength of the responses to 66-45 kDa proteins were found to be low in the leprosy patients compared to the healthy contacts. Further, preliminary analysis with the subfractions of Fraction II produced a similar pattern, suggesting that the immune response to the antigens in the range of 66-45 kDa M. leprae proteins remains suppressed in subjects with clinical signs and symptoms of the disease.

T-cell receptor-gamma rearrangement and c-myb methylation in MNNG-exposed Bloom syndrome B-lymphoblastoid cells

The MNNG-exposed Bloom syndrome (BS) B-lymphoblastoid cell population (BS-MNNG), when analyzed for aberrant genetic variations, showed an illegitimate rearrangement at the TCR-gamma gene and hypermethylation at the c-myb protooncogene. The TCR-gamma rearrangement involved a Vgamma9 segment corresponding to a 4 kb band detected with a Jgamma-specific probe in HindIII-digested DNA samples from BS-MNNG cells only. These variations were not shown by unexposed BS cells or both MNNG-exposed and unexposed normal (GA3) B-lymphoblastoid cells.

Genetic variations at the T cell receptor gamma locus in circulating peripheral blood mononuclear cells of clinically categorised leprosy patients

The allelic polymorphisms at exon 3 and exon 2 of the T cell receptor (TCR) C gamma 2 (TRGC2) gene, generating 18-kb and 5.4-kb HindIII fragments, respectively, were found to be more frequent in multibacillary leprosy patients than in the controls (P < 0.005 and P < 0.001, respectively) when screened with the IDP2.11 probe. The frequencies of heterozygotes for the 18-kb allele and homozygotes for the 5.4-kb allele were found to be significantly higher in the multibacillary patients than in the controls (P < 0.001). Interestingly, the 8.0-kb allele, originating from the triplication of exon 2 of C gamma 2, was observed exclusively in the paucibacillary leprosy patients. Further, when DNA samples were screened with the pH60 probe for the HindIII RFLP at the TCR J gamma 2 (TRGJ2) gene segment, the 2.1-kb allele was again more prevalent in leprosy patients with the multibacillary form of the disease than in the paucibacillary patients and the controls (P < 0.025). The frequency of homozygotes for the 2.1-kb allele was also significantly higher in the multibacillary patients than in the paucibacillary patients (P < 0.010) and the controls (P < 0.025). A significant difference was observed in the frequencies of detectable rearrangements involving the V gamma 7/8 and V gamma 9 gene segments at the gamma locus between circulating peripheral blood mononuclear cells of the multibacillary leprosy patients and the controls. These rearrangements were detected less frequently in the multibacillary patients (P < 0.001 for V gamma 7/8 and P < 0.005 for V gamma 9).

Association of polymorphism at COL3A and CTLA4 loci on chromosome 2q31-33 with the clinical phenotype and in-vitro CMI status in healthy and leprosy subjects: a preliminary study

Two genetic loci, viz. COL3A and CTLA4, located within the chromosome 2q31-33 region in the vicinity of the proposed syntenic site of the mouse "Bcg" locus were genotyped by the polymerase chain reaction in leprosy patients and healthy individuals. All the subjects studied were assessed as in-vitro responders/non-responders to mycobacterial antigens. Simple sequence length polymorphism analysis revealed five (236 to 312 bp) and eight (84 to 120 bp) allelomorphs for COL3A and CTLA4, respectively. Our preliminary analysis showed a significant association between the 250-bp COL3A allelomorph in the homozygous condition and the multibacillary form of leprosy (P < 0.05: relative risk = 5.5). Another allelic (312 bp) variant of COL3A was significantly correlated with non-responsiveness to M. leprae antigens in vitro (P < 0.01). The 104-bp allelomorph of CTLA4 was not observed in any of the 25 cases of leprosy. This absence was statistically significant (P < 0.05) when compared with normal healthy controls and depicted a high relative risk (RR = 25.83). An additional observation of the predominance of a unique 84-bp CTLA4/CTLA4-like allelomorph was observed in the Indian subjects studied.

Noise-free chemiluminescent detection of human T cell receptor and interleukin-2 receptor genes after optimization of digoxigenin labeled probe concentration

Reduction in the background problems to improve the efficiency of nonradioactive labeling and detection procedure has been the focus of attention in the recent past for wider acceptance of the technique in nucleic acid research. We have achieved success in obtaining a relatively background free detection of single copy genes such as, T-cell receptor-delta (TCR-delta) and interleukin-2 receptor (L-2r) in human genome by using optimized concentrations of the digoxigenin labeled probes. Inclusion of such an optimization step for each probe before carrying out the actual hybridization experiment did not require any further modification in hybridization conditions and detection protocols as suggested earlier [Anal Biochem, 210 (1993) 235; Colloq Boehringer Mannheim, 2 (1991) 4.]

Biliary lipid composition in patients with non-cirrhotic portal fibrosis--a comparison with compensated cirrhosis of the liver

Patients with non-cirrhotic portal fibrosis (NCPF) are known to have mild hepatic functional abnormalities. To study the biliary lipid composition in these patients, duodenal bile was collected from 18 patients with NCPF, 15 patients with non-alcoholic compensated cirrhosis of the liver and 18 matched, non-obese, healthy control subjects. There were no significant differences in the mean (+/- SD) concentrations of cholesterol, phospholipids and bile acids in patients with NCPF and healthy controls. On the other hand, patients with cirrhosis had significantly lower concentrations of all the three biliary lipids as compared with the NCPF patients and controls (p less than 0.05). The cholesterol solubilizing capacity of the bile was the same in NCPF patients, cirrhotics and controls. It is concluded that the relative proportions of the three biliary lipids remain unchanged in patients with NCPF despite mild hepatic derangement.