Lipopolysaccharides and Beta-Glucuronidase Activity in Choledochal Bile in Relation to Choledocholithiasis

• Published in: Digestion Vol. 58; no. 5; pp. 437 - 443
• Main Authors: Osnes, T., Sandstad, O., Skar, V., Osnes, M.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.1997; S. Karger AG
• Subjects: Aged; Bile - chemistry; Bile - microbiology; Biological and medical sciences; Diverticulum - complications; Duodenal Diseases - complications; Female; Gallstones - complications; Gallstones - epidemiology; Gallstones - metabolism; Gallstones - microbiology; Gastroenterology. Liver. Pancreas. Abdomen; Glucuronidase - metabolism; Gram-Negative Bacteria - metabolism; Humans; Limulus Test; Lipopolysaccharides - metabolism; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Logistic Models; Male; Medical sciences; Original Paper; Other diseases. Semiology; Limulus test; Duodenal diverticula; Endoscopic retrograde cholangiopancreatography; Gram-negative bacteria; Common bile duct calculi; Endotoxins; Human; Cholangiopancreatography; Evaluation; Radiodiagnosis; Pathophysiology; Glucuronic acid conjugation; Biliary tract disease; Biological activity; Infection; Association; Choledoch; Arthropoda; Merostomata; Bacteriosis; Limulus; Lipopolysaccharide; Lithiasis; Digestive diseases; Endoscopy; Invertebrata; Predictive factor; Gram negative bacteria
• ISSN: 0012-2823; 1421-9867
• DOI: 10.1159/000201480

Common duct gallstones are mainly of the brown pigment type, which are usually attributed to bacterial factors. Bacterial β-glucuronidase most probably plays a role in the pathogenesis in many but not all patients. The role of other bacterial factors is more undecided. The aims of this study were to investigate a possible association between lipopolysaccharides (LPS) and choledocholithiasis, and to examine the interrelationship to β-glucuronidase. Common duct bile obtained at endoscopic retrograde cholangiography in 86 patients was assayed for LPS by a limulus amebocyte lysate test, and β-glucuronidase activity at pH 7.0 was measured. We found that both elevated concentration of LPS and the presence of juxtapapillary duodenal diverticula were associated with common duct stones (p < 0.01, both). Patients who had their common duct stones removed recently had a lower LPS concentration and a lower activity of β-glucuronidase than those who had a stone in situ (p < 0.01 both), but still higher LPS concentration than those without choledocholithiasis at all (p < 0.01). In multiple logistic regression analysis, elevated LPS was the significant predictor of common duct stones (p < 0.01), and not confounding with neither β-glucuronidase nor juxtapapillary diverticula. We conclude that gram-negative bacteria convey bacterial factors associated with choledocholithiasis, by mechanisms independent of, and additional to β-glucuronidase.