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Bile Infection and Bile Acids Concentration in Bile in Acute Biliary Pancreatitis

100%

Zasada J., Panek J., Dolecki M., Biesiada Z., Dembiński M.

issue 12

655-669

Biliary stones are the most common etiology of acute pancretitis (AP). Pathomechanism of this etiology is based on common channel theory of Opie.Material and methods. 113 patients with ABP were included in the study - 91 with mild and 22 with severe form of ABP. 17 patients with cholelithiasis and choledocholithiasis without ABP served as controls. All the patients were submitted to the same model of treatment. Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sfincterotomy (ES) were performed in the day of admission and laparoscopic cholecystectomy within the next 24 hours. Bile specimens were taken from main bile duct (MBD) during ERCP and from gall-bladder (GB) during laparoscopic cholecystectomy. Bacteriological cultures, bile acids (BA) concentration and total and secretory form of IgA concentration were assessed in particular groups of patients.Results. No significant statistical differences of bile infection in MBD and GB were found between the analyzed groups of patients. Furthermore, the bile among the patients with severe ABP was more frequently infected, particularly when obtained from gall-bladder. Most common pathogens found in cultures were Gram negative bacteria. Interestingly, Gram positive cultures and fungi were also significant. The number of species of pathogens was of no significance for infection concerning both: source of bile and groups of patients. Mean concentrations of total BA were different between study groups of patients in MBD and in GB. It is worth mentioning, that the fraction of hydrophobic, secondary BA which are potentially more toxic, was increased in total concentration of BA in MBD particularly in patients with severe form of AP. Among patients with mild AP and controls these values were lower and similar.Conclusions. It seems that BA play as an aggressive factor during AP while in physiologic condition have a protective, antibacterial meaning.

Rola 7α- hydroksylazy cholesterolu i genu CYP7A1 w fi zjologii i patologii człowieka

75%

Iwanicki T., Balcerzyk A., Żak I.

Annales Academiae Medicae Silesiensis

2010

vol. 64

issue 3-4

48-57

Cholesterol 7α- hydroxylase (CYP7A1) belongs to the big family of cytochrome p450. Biological signifi cance of cholesterol 7α- hydroxylase is associated with beginning of cholesterol transformation to the bile acids. CYP7A1 affi nity to the cholesterol is determined by its unique protein structure, diff erent from the other proteins of cytochrome p450 family. CYP7A1 enzyme is enoded by CYP7A1 gene localized in short arm of chromosome 8. Expression of CYP7A1 gene could be regulated by farnesoid X receptor (FXR) or by kinases, which modulate nuclear receptor`s binding abilities to the gene promoter. Polymorphic variants and mutations present in the promoter region impact on the quality properties of the enzyme. CYP7A1 gene, encoding key enzyme of the cholesterol catabolic pathway is a main candidate to the research of its association with changes of serum lipids levels. Presence of genetic variants can be associated with changed levels of total cholesterol, triglycerides and Low- density lipoproteins (LDL). Promoter polymorphism of CYP7A1 is also main candidate for the research of association with such disease entities as gallbladder stone formation, colon cancer, gallbladder cancer or atherogenic- based diseases.

7α- hydroksylaza cholesterolu (CYP7A1) jest enzymem należącym do dużej rodziny cytochromu p450. Znaczenie biologiczne 7α- hydroksylazy cholesterolu związane jest z rozpoczęciem szeregu przemian cholesterolu do kwasów żółciowych. Powinowactwo CYP7A1 do cholesterolu determinowane jest unikalną budową białka, odmienną od reszty białek rodziny cytochromu p450. Enzym ten kodowany jest przez gen CYP7A1, którego locus znajduje się na ramieniu krótkim chromosomu ósmego. Ekspresja tego genu może być regulowana przy udziale farnezylowego receptora X (FXR), bądź zachodzić poprzez szereg kinaz białkowych, modulujących zdolność przyłączania się swoistych receptorów jądrowych do promotora CYP7A1. Warianty polimorfi czne i mutacje, występujące w regionie promotorowym, wpływają na właściwości jakościowe enzymu. Gen CYP7A1, kodując kluczowy enzym w katabolizmie cholesterolu, jest głównym kandydatem do badań jego związku ze zmianami w osoczowym poziomie lipoprotein. Obecność wariantów genetycznych w promotorze genu CYP7A1 może być związana ze zmienionym poziomem cholesterolu całkowitego, triacylogliceroli czy LDL (Low- Density Lipoprotein). Polimorfizm promotora genu kodującego kluczowy enzym szlaku syntezy kwasów żółciowych i usuwania cholesterolu z organizmu jest głównym kandydatem do badań asocjacyjnych z takimi jednostkami chorobowymi, jak kamica żółciowa, nowotwory jelita grubego i woreczka żółciowego czy choroby o podłożu miażdżycowym.

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1 Annales Academiae Medicae Silesiensis

1 Polish Journal of Surgery

1 2010

1 2009

1 Balcerzyk A.

1 Biesiada Z.

1 Dembiński M.

1 Dolecki M.

1 Iwanicki T.

1 Panek J.

1 Zasada J.

1 Żak I.

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Bile Infection and Bile Acids Concentration in Bile in Acute Biliary Pancreatitis

Rola 7α- hydroksylazy cholesterolu i genu CYP7A1 w fi zjologii i patologii człowieka