The distribution and monomer activity of cholesterol in micellar solution - its significance in gallstone formation -

为了阐明胆固醇结石形成的原因，本研究比较了有无胆结石的胆囊壁的胆固醇分布、胆固醇单体活性以及胆汁中与成核时间相关的胆脂和蛋白质浓度的差异。两组患者均为胆石症患者或肝胆疾病以外的其他疾病患者，术中直接针刺取胆汁。通过0.22um膜过滤去除胆固醇晶体的胆汁具有相似的胆汁脂和胆汁蛋白浓度。两组间胆固醇单体活性无显著差异。在胆结石患者中，成核时间明显更快。由于胆石组的成核时间延长，通过XM-300膜的滤液具有相似的成核时间。在胆结石患者中，这种过滤保留了更多的胆固醇、磷脂和胆汁蛋白，而胆盐的过滤速度在两组之间相似。这些结果表明，不能通过XM-300膜的蛋白质而不是总蛋白质对胆固醇一水合物的结晶起作用。去除主要由胆固醇和磷脂组成的囊泡会延长成核时间。胆固醇单体活性和胆固醇饱和指数不能区分胆固醇结石疾病和对照。

The differences in cholesterol distribution, cholesterol monomer activity and the concentrations of biliary lipids and protein related with nucleation time between the gallbladder biles with and without gallstone were examined to clarify the etiology of cholesterol gallstone formation. Gallbladder biles were obtained by the direct needle puncture at surgery from two groups of patients with cholelithisasis or with diseases other than hepatobiliary disease. The filtered biles through the 0.22 um membrane to remove cholesterol crystals had similar concentrations of biliary lipids and biliary proteins. Cholesterol monomer activity was not significantly different between two groups. nucleation time was significantly faster in gallstone patients. The filtrate through the XM-300 membrane had a similar nucleation time due to the prolonged nucleation time in gallstone group. This filtration retained more cholesterol, phospholipid and biliary protein in gallstone patients, while the filtration rate of bile salt was similar between two groups. These results suggest that the protein which cannot pass through the XM-300 membrane but not the total protein is responsible for cholesterol monohydrate crystallization. The removal of vesicles mainly composed of cholesterol and phospholipid prolongs the nucleation time. Cholesterol monomer activity as well as cholesterol saturation index cannot distinguish cholesterol gallstone disease from control.