Immunohistochemical and immunoelectron microscopic analyses of alpha-amylase isozymes in human intrahepatic biliary epithelium and hepatocytes.

The expression and localization of the pancreatic and salivary isozymes of alpha-amylase in the intrahepatic biliary epithelium and hepatocytes were examined by the immunohistochemical method with polyclonal and monoclonal antibodies in 45 normal autopsied human livers. Immunoelectron microscopic studies with the protein A-gold method were performed with the monoclonal antibodies (MAb) on seven of the livers. The intrahepatic biliary system was divided into large ducts, septal ducts, interlobular ducts, bile ductules, and peribiliary glands. Immunohistochemically, pancreatic isozyme was observed in the supranuclear cytoplasm of the epithelium of large ducts, septal ducts, and peribiliary glands in almost all livers. Interlobular ducts expressed pancreatic isozyme in only four (9%) livers. Bile ductules and hepatocytes were negative for pancreatic isozyme in all cases. Expression of salivary isozyme was observed in the supranuclear cytoplasm of the epithelium of large ducts, septal ducts, interlobular ducts, bile ductules, and peribiliary glands in almost all livers, although the expression in interlobular ducts and bile ductules was weak. Hepatocytes were weakly positive for salivary isozyme. Immunoelectron microscopy revealed that both pancreatic and salivary isozymes were located in the supranuclear cytoplasm of the epithelium of large ducts, septal ducts, and peribiliary glands, and that hepatocytes had no pancreatic isozyme but contained salivary isozyme. These data suggest that pancreatic and salivary isozymes of alpha-amylase are produced by the intrahepatic biliary epithelium and secreted into intrahepatic biliary lumens, and that they may play an important role in the physiology of the intrahepatic biliary tree and hepatic bile. It is also suggested that hepatocytes produce a small amount of salivary alpha-amylase that may be secreted into the biliary tree.     

Expression of neural cell adhesion molecule in human liver development and in congenital and acquired liver diseases

In the liver, neural cell adhesion molecule (NCAM) is a marker of immature cells committed to the biliary lineage and is expressed by reactive bile ductules in human liver diseases. We investigated the possible role of NCAM in the development of intrahepatic bile ducts and aimed at determining whether immature biliary cells can contribute to the repair of damaged bile ducts in chronic liver diseases. Therefore, we performed immunohistochemistry for NCAM and bile duct cell markers cytokeratin 7 and cytokeratin 19 on frozen sections of 85 liver specimens taken from 14 fetuses, 10 donor livers, 18 patients with congenital liver diseases characterized by ductal plate malformations (DPMs), and 43 cirrhotic explant livers. Duplicated ductal plates and incorporating bile ducts during development showed a patchy immunoreactivity for NCAM, while DPMs were continuously positive for NCAM. Bile ducts showing complete or patchy immunoreactivity for NCAM were found in cirrhotic livers, with higher frequency in biliary than in posthepatitic cirrhosis. Our results suggest that NCAM may have a function in the development of the intrahepatic bile ducts and that NCAM-positive immature biliary cells can contribute to the repair of damaged bile ducts in chronic liver diseases.     

Regeneration of intrahepatic biliary ducts after subtotal hepatectomy in rats

The regenerative morphogenesis of intrahepatic biliary ducts in subtotally hepatectomized rats was studied at 3, 7, 14 and 21 days after operation. Histological findings showed that during the postmitotic stage of hepatoregeneration, between the 1st and 2nd postoperatory week the regenerated biliary structures appeared in close connection with the newly formed vasculo-connective portal spaces. The poorly differentiated periportal cells generated through a gradual metamorphosis the bordering cells of the regenerating intrahepatic biliary ducts. These plead for the similarity of histogenetic mechanisms in regenerative and embryofetal cholangiogenesis.     

Morphological changes in the liver of the sea lamprey, Petromyzon marinus L., during metamorphosis: I. Atresia of the bile ducts

The bile ducts in the liver of larval sea lamprey, Petromyzon marinus, undergo programmed degeneration during metamorphosis. The degenerative process is most dramatic in the middle metamorphic stages (3-5), and is asynchronous, occurring more rapidly in small peripheral biliary components than in larger, medial ducts. All classes of bile ducts within the biliary tree exhibit similar histological changes during regression. The initial evidence of degeneration in the epithelium is a folding of the basal lamina, and this is accompanied by cell shrinkage and disruption of cell order. "Shedding" of microvilli and cytoplasmic constituents then takes place at the apical surface resulting in the accumulation of periodic acid-Schiff positive membranous debris in the Lumen. The appearance of "hyalin bodies" in the lumen coincides with the depletion of intermediate-sized filaments from the cytoplasmic matrix. Numerous, large dense bodies, myelin figures, and autophagic vacuoles are consistently observed in necrotic cells. Following cytolysis, bile duct remnants become ensheathed within regions of fibrosis. Ultimately, these fibrous regions are replaced with cords of hepatocytes. By stage 7, all bile ducts have disappeared. The events of biliary atresia in lampreys are comparable to tissue regression which is associated with normal development and pathological conditions in other vertebrates but are particularly reminiscent of those in human biliary atresia. The unique ability of the adult lamprey to service without bile ducts enhances the value of this organism as an experimental model for studying human biliary atresia.     

Ultrasonography of the bile ducts after cholecystectomy]

The paper is concerned with the results of multiprojectional ultrasound investigation of the biliferous system in 68 patients at varying time after cholecystectomy. In most cases (77.9%) signs of dilated biliary ducts were undetectable. Dilatation of the hepaticodoch was most frequently determined by choledolithiasis, stricture or stenosing papillitis, rarely--by pancreatic head cancer. Investigation of the biliary ducts in patients after cholecystectomy should be started with ultrasound tomography; endoscopic retrograde cholangiopancreatography or i.v. cholangiography and dynamic cholescintigraphy were indicated after the detection of the signs of dilated ducts (the anteroposterior diameter of the common hepatic duct was over 6 mm).     

The relation between structure and function of bile ducts in man, some laboratory animals and the Adelie penguin.

The biliary trees of man, dog, cat, rabbit, rat, guinea pig and penguin were examined in histological sections and by latex casts. The trees of man, dog, and cat were similar with only minor differences. Tubulo-alveolar glands were present in all three species around large intrahepatic ducts and in large portal tracts there were zones of ductules (areas with many small bile ducts), surrounded by small vessels with no apparent relation to hepatocytes. Both these features were present in the guinea pig and tubulo-alveolar glands were present in the penguin liver. The biliary epithelium of the rat was comparatively simple but that of the rabbit appeared to be highly specialized. An estimation of the complexity of the biliary tree was obtained in the mammals by comparing the circumference of small portal venous branches with the circumference of the accompanying bile ducts, and obtaining a ratio. Man, dog, and cat had fewer and smaller bile ducts than the other species. The literature on the rate of formation and composition of bile in the species studied here was reviewed and it appears that the physiology of bile secretion can be related to the morphology of the biliary tree.     

Direct cholangiography: its diagnostic and therapeutic role.

In the management of biliary tract disorders, direct cholangiography should be chosen over ultrasonic examination if the bile ducts are thought to be obstructed. Contrast medium can be introduced into the bile ducts either percutaneously or retrogradely via the ampulla of Vater, the choice of technique often depending on the clinical situation. Direct access to the biliary tree for diagnostic purposes has also led to advances in the treatment of mechanical disorders of the ducts.     

Development of the seminiferious tubules and rete testis during the prenatal period of human ontogenesis

The sources of origin and the peculiarities of formation of the seminal ducts and rete testis during the prenatal period of ontogenesis in man were studied. It has been established that the seminal duct sand the ducts of the rete testis form from the cellular cords of the coelomic epithelium and the primordial germ cells which appear simultaneously in the septum of the testis and the primordial germ cells which appear simultaneously in the septum of the testis and central part of its parenchyma in the embryos, 13.0--17.0 mm long. By plastic and graphic reconstruction, as well as by methods of subtle preparation under binocular microscope MBC-I control it was revealed that the seminal ducts anastomosed between themselves both within the limits of one and the adjacent lobules. The ducts of the rete testis do not form anastomoses, but superimpose over one another, creating an impression of a rete. Approaching the tunica albuginea they merge, continuing into the cuctuli efferentes testis.     

Experimental bases of directed transport of antibiotics in suppurative-inflammatory diseases of the liver and biliary tract

The possibility of use and effectiveness of directed transport of antibiotics in erythrocyte carriers in the treatment of suppurative-inflammatory diseases of biliary ducts has been studied on dogs. It has been found that erythrocyte carriers were resistant to desorption of antibiotics in the blood circulation. Pharmacokinetic investigation has shown the more prolonged collection of antibiotics in hepatic tissue in comparison with traditional intravenous route. The results of clinical, pharmacokinetic and morphological investigation have shown more effectiveness of directed transport of antibiotics to the liver in autologous erythrocyte carriers in treatment of suppurative diseases of biliary ducts in comparison with traditional methods of infusion of antibiotics. For reasons given it is recommended to use this method in clinical practice.     

Isolation of Neonatal Extrahepatic Cholangiocytes

The intra and extrahepatic bile ducts of the liver are developmentally distinct, and may be differentially affected by certain diseases. However, differences between intra and extrahepatic cholangiocytes, and between neonatal and adult cells, are not well understood.Methods for the isolation of cholangiocytes from intrahepatic bile ducts are well established^1-4. Isolation of extrahepatic ductal cells, especially from the neonate, has not yet been described, although this would be of great benefit in understanding the differences between distinct cholangiocyte populations and in studying diseases such as biliary atresia that appear to target the extrahepatic ducts. Described here is an optimized technique to isolate both neonatal and adult mouse extrahepatic bile duct cells. This technique yields a pure cell population with minimal contamination from mesenchymal cells like fibroblasts.This method is based on the removal of the extrahepatic ducts and gallbladder, followed by meticulous dissection and scraping to remove fat and fibroblast layers. Structures are embedded in thick layers of collagen and cultured for approximately 3 weeks to allow outgrowth of cholangiocytes in monolayers, which can then be trypsinized and re plated for experimental use.     

INTRAVENOUS CHOLANGIOGRAPHY—Some Observations on the Use of Cholografin

Intravenous cholangiography with cholografin is a safe procedure, most useful for the study of patients who have had cholecystectomy and later have symptoms related to the biliary ducts.When jaundice or liver impairment is present, the examination is usually unsuccessful. However, these conditions are not absolute contraindications to the procedure. There may be failure to visualize the biliary ducts even in the presence of a normal liver.Planigraphy is helpful in eliminating confusing superimposed structures and when there is only faint visualization of the common duct.Intravenous cholecystography is only of questionable value as a supplementary examination to oral cholecystography. It may prove useful in certain instances when patients are unable to retain or absorb the oral media or where emergency operation is contemplated.     

Intravenous cholangiography; some observations on the use of cholografin

Intravenous cholangiography with cholografin is a safe procedure, most useful for the study of patients who have had cholecystectomy and later have symptoms related to the biliary ducts. When jaundice or liver impairment is present, the examination is usually unsuccessful. However, these conditions are not absolute contraindications to the procedure. There may be failure to visualize the biliary ducts even in the presence of a normal liver. Planigraphy is helpful in eliminating confusing superimposed structures and when there is only faint visualization of the common duct. Intravenous cholecystography is only of questionable value as a supplementary examination to oral cholecystography. It may prove useful in certain instances when patients are unable to retain or absorb the oral media or where emergency operation is contemplated.     

Contribution of Mature Hepatocytes to Biliary Regeneration in Rats with Acute and Chronic Biliary Injury

Whether hepatocytes can convert into biliary epithelial cells (BECs) during biliary injury is much debated. To test this concept, we traced the fate of genetically labeled [dipeptidyl peptidase IV (DPPIV)-positive] hepatocytes in hepatocyte transplantation model following acute hepato-biliary injury induced by 4,4’-methylene-dianiline (DAPM) and D-galactosamine (DAPM+D-gal) and in DPPIV-chimeric liver model subjected to acute (DAPM+D-gal) or chronic biliary injury caused by DAPM and bile duct ligation (DAPM+BDL). In both models before biliary injury, BECs are uniformly DPPIV-deficient and proliferation of DPPIV-deficient hepatocytes is restricted by retrorsine. We found that mature hepatocytes underwent a stepwise conversion into BECs after biliary injury. In the hepatocyte transplantation model, DPPIV-positive hepatocytes entrapped periportally proliferated, and formed two-layered plates along portal veins. Within the two-layered plates, the hepatocytes gradually lost their hepatocytic identity, proceeded through an intermediate state, acquired a biliary phenotype, and subsequently formed bile ducts along the hilum-to-periphery axis. In DPPIV-chimeric liver model, periportal hepatocytes expressing hepatocyte nuclear factor-1β (HNF-1β) were exclusively DPPIV-positive and were in continuity to DPPIV-positives bile ducts. Inhibition of hepatocyte proliferation by additional doses of retrorsine in DPPIV-chimeric livers prevented the appearance of DPPIV-positive BECs after biliary injury. Moreover, enriched DPPIV-positive BEC/hepatic oval cell transplantation produced DPPIV-positive BECs or bile ducts in unexpectedly low frequency and in mid-lobular regions. These results together suggest that mature hepatocytes but not contaminating BECs/hepatic oval cells are the sources of periportal DPPIV-positive BECs. We conclude that mature hepatocytes contribute to biliary regeneration in the environment of acute and chronic biliary injury through a ductal plate configuration without the need of exogenously genetic or epigenetic manipulation.     

Drug-induced bile duct injury

Drug-induced liver injury includes a spectrum of pathologies, some related to the mode of injury, some to the cell type primarily damaged. Among these, drug-induced bile duct injury is characterized by the destruction of the biliary epithelium following exposure to a drug. Most of the drugs associated with bile duct injury cause immune-mediated lesions to the epithelium of interlobular ducts. These share common histopathological features with primary biliary cholangitis, such as inflammation and necrosis at the expense of cholangiocytes and, if the insult persists, bile duct loss and biliary cirrhosis. Some drugs selectively target larger ducts. Such injury is often dose-dependent and thought to be the result of intrinsic drug toxicity. The histological changes resemble those seen in primary sclerosing cholangitis. This overview focuses on the clinical and pathological features of bile duct injury associated with drug treatment and on the immunological and biochemical effects that drugs exert on the biliary epithelium. This article is part of a Special Issue entitled: Cholangiocytes in Health and Disease edited by Jesus Banales, Marco Marzioni, Nicholas LaRusso and Peter Jansen.     

Structure of the excretory ducts, intraorganic lymphatic vessels, tissue canals and intercellular space of various organs (data of scanning electron microscopy injection replicas)

Architectonics of the biliary canaliculi and intrahepatic ducts systems, as well as intraorganic urinary pathways in white rats have been investigated by means of scanning electron microscopy of injection replica. Acinar structure of the intralobular part of the biliary bed has been proved. Anastomoses between the biliary canaliculi of the neighbouring lobules have been demonstrated. A useful method for obtaining injection replica of the intraorganic lymphatic vessels is filling of the ductal system of the parenchymatous organs with solid resins (methylmethacrylate+) under a high (nonphysiological) pressure. Casts of periportal and paravenous hepatic lymphatic vessels have been obtained. An ability of methylmethacrylate to replicate intercellular and connective tissue spaces is verified. Casts of the perisinusoid spaces (Disse) are obtained for the first time.     

Interaction of CD44 and hyaluronic acid enhances biliary epithelial proliferation in cholestatic livers

Biliary epithelia express high levels of CD44 in hepatobiliary diseases. The role of CD44-hyaluronic acid interaction in biliary pathology, however, is unclear. A rat model of hepatic cholestasis induced by bile duct ligation was employed for characterization of hepatic CD44 expression and extracellular hyaluronan distribution. Cell culture experiments were employed to determine whether hyaluronan can regulate cholangiocyte growth through interacting with adhesion molecule CD44. Biliary epithelial cells were found to express the highest level of CD44 mRNA among four major types of nonparenchymal liver cells, including Kupffer, hepatic stellate, and liver sinusoidal endothelial cells isolated from cholestatic livers. CD44-positive biliary epithelia lining the intrahepatic bile ducts were geographically associated with extracellular hyaluronan accumulated in the portal tracts of the livers, suggesting a role for CD44 and hyaluronan in the development of biliary proliferation. Cellular proliferation assays demonstrated that cholangiocyte propagation was accelerated by hyaluronan treatment and antagonized by small interfering RNA CD44 or anti-CD44 antibody. The study provides compelling evidence to suggest that proliferative biliary epithelia lining the intrahepatic bile ducts are a prime source of hepatic CD44. CD44-hyaluronan interaction, by enhancing biliary proliferation, may play a pathogenic role in the development of cholestatic liver diseases.     

Fine reconstruction of the pancreatic ductular system at the onset of pancreatitis

The three-dimensional structure of the pancreatic ductular system (from the intercalated duct to the intercellular secretory canaliculus) is controversial and unclear. The aim of this study is to reveal the three-dimensional structure of the pancreatic ductular sysytem at the onset of pancreatitis. One day following rat pancreatic duct ligation, dilated lumina from the pancreatic ductular system were reconstructed by light microscopic and scanning electron microscopic examination of pancreatic tissue serial sections. The existence of the intra-acinar duct, which is formed only by centroacinar cells and interconnects the adjacent central lumina in an acinus, was demonstrated. The intercellular secretory canaliculi, which are the terminal parts of the pancreatic ductular system, anastomose and end blindly in the intercellular space located between adjacent lateral surfaces of the acinar cells. The intercalated ducts, the intra-acinar ducts, the central lumina, and the intercellular secretory canaliculi are arranged together in a complex connecting and branching system. However, there were no anastomoses found among the central lumina or acini.     

Regulation of intrahepatic biliary duct morphogenesis by Claudin 15-like b

The intrahepatic biliary ducts transport bile produced by the hepatocytes out of the liver. Defects in biliary cell differentiation and biliary duct remodeling cause a variety of congenital diseases including Alagille Syndrome and polycystic liver disease. While the molecular pathways regulating biliary cell differentiation have received increasing attention (Lemaigre, 2010), less is known about the cellular behavior underlying biliary duct remodeling. Here, we have identified a novel gene, claudin 15-like b (cldn15lb), which exhibits a unique and dynamic expression pattern in the hepatocytes and biliary epithelial cells in zebrafish. Claudins are tight junction proteins that have been implicated in maintaining epithelial polarity, regulating paracellular transport, and providing barrier function. In zebrafish cldn15lb mutant livers, tight junctions are observed between hepatocytes, but these cells show polarization defects as well as canalicular malformations. Furthermore, cldn15lb mutants show abnormalities in biliary duct morphogenesis whereby biliary epithelial cells remain clustered together and form a disorganized network. Our data suggest that Cldn15lb plays an important role in the remodeling process during biliary duct morphogenesis. Thus, cldn15lb mutants provide a novel in vivo model to study the role of tight junction proteins in the remodeling of the biliary network and hereditary cholestasis.     

The importance of the lysophosphatidylcholine and choline moiety of bile phosphatidylcholine in lymphatic transport of fat

A luminal supply of biliary phosphatidylcholine is important in the translocation of absorbed fat into lymph and in the amount and composition of phosphatidylcholine concurrently synthesized. This study was undertaken to determine whether the effect was due to absorbed lysophosphatidylcholine, to a specific (1-palmitoyl) biliary lysophosphatidylcholine or to extra choline supplied by lysophosphatidylcholine. Rats with bile fistulae and thoracic duct lymph fistulae were given test meals of oleic acid and monoolein (molar ratio 2 : 1) infused duodenally for 8 h. Addition of choline chloride to the test meal increased lymphatic output of triglyceride and phospholipid but not to values found previously in rats with supplements of bile phosphatidylcholine or with bile ducts intact. Addition of dioleoyl phosphatidylcholine increased triglyceride and phospholipid output to values found in rats with intact bile ducts. Since dioleoyl phosphatidylcholine was as efficient as biliary phosphatidylcholine it was concluded that a luminal supply of 1-palmitoyl lysophosphatidylcholine was not essential. It seemed likely from the smaller effect of supplemented choline and from the fatty acid composition of lymph phosphatidylcholine that the essential requirement was a supply of absorbed lysophosphatidylcholine for rapid reacylation to phosphatidylcholine.