Bile secretion in the fistulated pig: effect of the method used for bile reinfusion

The aim of this work was to investigate the effects on bile secretion of flow rate and site of reinfusion of the collected bile to the animal. Thirty-two pigs weighing 50 +/- 3 kg at the beginning of the experiment were fitted with a reentrant fistula in the lower common bile duct and in the upper duodenum. Bile collected from the bile duct was reinfused in four different ways (four groups of 8 animals each): into the duodenum or the lower common bile duct at a constant flow rate using a peristaltic pump, or into the duodenum or the lower common bile duct at a rate mimicking the flow rate of the secretion using an automatic apparatus. Reinfusing the bile into the lower common bile duct at a rate mimicking the secretion rate provided a daily bile acid production about 21% higher than the level recorded with the other three methods. This was mainly due to a higher bile acid concentration since the bile flow was only slightly affected by the treatment.     

Hemorrhage with blood reinfusion and the relationship between gastroduodenal motility and bile reflux in rats

The relationship between gastroduodenal motility and bile reflux was studied in normal rats and in rats subjected to hemorrhage and blood reinfusion. Bile secretion decreased from 5.3 +/- 0.4 to 4.1 +/- 0.5 microL/(min.100 g rat) (p less than 0.05) during the hypovolemic stress and recovered after blood reinfusion. Gastric bile salt content was low (0.1 +/- 0.03 mumol/(h.100 g rat] during control period and hemorrhage but increased to 0.7 +/- 0.12 mumol/(h.100 g rat) (p less than 0.001) during the 3 h following blood replacement. Marked gastric and duodenal retention of polyethylene glycol was observed immediately after hypovolemia with the former being evident even after 3 h following blood reinfusion, while duodenal emptying recovered rapidly after reinfusion. The frequency of gastric contraction remained unchanged during hemorrhage but decreased after 90 min following blood replacement, whereas the frequency of duodenal contraction abruptly decreased during hemorrhage and recovered after reinfusion. Both gastric and duodenal contractile pressure was significantly decreased during hemorrhage. After reinfusion, the former remained suppressed while the latter was fully recovered within 1 h. Thus, a significant duodenogastric bile reflux observed after reinfusion was due to a higher duodenal contractile pressure, and the uncoordinated gastroduodenal motility with the duodenal motility fully recovered soon after reinfusion while that of the stomach remained suppressed.     

The role of the duodenojejunal junction in regulating the evacuatory function of the duodenum

Chronic experiment on dogs was performed to study the effect of duodenojejunal junction exclusion from the evacuatory process on dynamics of gastric and duodenal emptying of the carbohydrate and fatty food. It is established that in the case of exclusion of the duodenojejunal junction, the degree of coordination of gastric and duodenal emptying decreases, dynamics of chyme evacuation from the duodenum considerably changes. It is concluded that the duodenum is not a mere transporter of food coming from the stomach, but has its own regulation mechanisms represented by the duodenojejunal junction and the Treitz ligament.     

Exogenous and endogenous contribution to nitrogen fluxes in the digestive tract of pigs fed a casein diet. I. Contributions of nitrogen from the exocrine pancreatic secretion and the bile

The aim of the present work was to study the endogenous contribution of the exocrine pancreatic and biliary secretions to the total endogenous nitrogen production in the pig. Three growing Large White pigs weighing 45 +/- 2.5 kg were fitted with permanent fistulae in the pancreatic duct, the bile duct and the duodenum. They were adapted to a semi-synthetic casein diet for 14 d before surgery. In a 7-d post-operative period and an 8-d experimental period, they were fed the same diet. Secretion rates were recorded, total nitrogen and TCA (trichloroacetic acid) insoluble nitrogen were determined in representative pancreatic juice and bile samples. Daily pancreatic juice and bile flow rates were very similar: 1,850 and 1,820 ml, respectively. The amount of endogenous total nitrogen secreted in the intestinal lumen was 3.6 g per day: 1.9 g N through pancreatic secretion and 1.7 g N through bile secretion. Pancreatic nitrogen increased after meal intake, whilst the kinetics of nitrogen production in the bile were not affected. Throughout the experiment, the mean percentage of TCA insoluble nitrogen was 78.1% in pancreatic juice and 72.3% in bile.     

Effects of nitric oxide synthase inhibitor on the digestive system measured by simultaneous monitoring of gastric motility, gastric emptying activity and postprandial pancreaticobiliary secretion in dogs.

Relationships between the NO synthase inhibitor and gastric and pancreaticobiliary functions measured simultaneously in the digestive state have been little studied. The aim of this study was to estimate the effect of NO synthase inhibitor on integrated digestive function in conscious dogs. A strain gauge force transducer was implanted on the gastric antrum of 6 mongrel dogs to measure gastric contractile activity and two duodenal cannulas were inserted into the proximal and distal sites to measure the gastric emptying rate and the pancreaticobiliary output into the duodenum using our novel method. Postprandial pancreatic and biliary secretion were presented as amylase and bile acid activity, respectively. Furthermore, a cervical cannula was placed into the superior vena cava as a route for the administration of NO synthase inhibitor, N omega-nitro-L-arginine (L-NNA), at a dose of 2.5 mg/kg-h. In a group given L-NNA, gastric contractile activity after ingestion was significantly enhanced, but the emptying rates of gastric solids and liquids were significantly suppressed in comparison with the control. The mean 0-1 h amylase integrated output was significantly (P < 0.05) decreased in comparison with the control, and the mean bile acid integration of 0-1 h output was also significantly (P < 0.01) decreased. A possible explanation for this observation is that smaller volumes of nutrient are delivered into the duodenum; however, it could also be that postprandial pancreaticobiliary secretion is inhibited by an alteration of blood flow or by a change in contractions of the sphincter of Oddi after the administration of L-NNA.     

Bile salts potentiate adenylyl cyclase activity and cAMP-regulated secretion in human gallbladder epithelium

Fluid and ion secretion in the gallbladder is mainly triggered by the intracellular second messenger cAMP. We examined the action of bile salts on the cAMP-dependent pathway in the gallbladder epithelium. Primary cultures of human gallbladder epithelial cells were exposed to agonists of the cAMP pathway and/or to bile salts. Taurochenodeoxycholate and tauroursodeoxycholate increased forskolin-induced cAMP accumulation to a similar extent, without affecting cAMP basal levels. This potentiating effect was abrogated after PKC inhibition, whereas both taurochenodeoxycholate and tauroursodeoxycholate induced PKC-alpha and -delta translocation to cell membranes. Consistent with a PKC-mediated stimulation of cAMP production, the expression of six adenylyl cyclase isoforms, including PKC-regulated isoforms 5 and 7, was identified in human gallbladder epithelial cells. cAMP-dependent chloride secretion induced by isoproterenol, a beta-adrenergic agonist, was significantly increased by taurochenodeoxycholate and by tauroursodeoxycholate. In conclusion, endogenous and therapeutic bile salts via PKC regulation of adenylyl cyclase activity potentiate cAMP production in the human gallbladder epithelium. Through this action, bile salts may increase fluid secretion in the gallbladder after feeding.     

The effect of body weight on the calcitonin gene-related peptide-induced relaxation of guinea pig gallbladder strips

Calcitonin gene-related peptide (CGRP) has been reported to relax, in a concentration-dependent manner, cholecystokinin-induced tension in guinea pig gallbladder strips. It is now shown that this CGRP-induced relaxation is body weight dependent with the degree of relaxation inversely related to weight. Radioimmunoassay demonstrated that the amount of CGRP in the gallbladder increased with body weight. Receptor binding showed that the number of binding sites and the affinity of the receptor decreased with increasing body weight. CGRP may play a role in the normal pattern of gallbladder contraction and relaxation. Decreased motility, even between periods of complete emptying, has been demonstrated to have a role in gallbladder diseases. The decreased sensitivity of the gallbladder to CGRP may explain the increase in abnormalities with age.     

Effects of chronic morphine on biliary tract responses to cholecystokinin-octapeptide in male guinea pigs.

Opioid peptides share the spasmogenic action of acutely administered morphine on the sphincter of Oddi. In this study, gallbladder function was assessed following chronic opioid administration. Implantation of morphine pellets (400 mg) in male guinea pigs depressed cholecystokinin-octapeptide(CCK)-induced emptying of gallbladder bile (monitored via a duodenal cannula). Gallbladder muscle strips, isolated from the morphine treated animals, showed depressed contractile responses to CCK. This antagonism was non-specific and indirectly mediated, as ACh contractions were also depressed, whereas CCK-induced contractions of gallbladder strips from untreated animals were unaffected by direct exposure to morphine (3 x 10(-6)M). The depression of CCK stimulation of bile flow by chronic morphine administration in male guinea pigs suggests that chronic exposure to opioids can impede gallbladder emptying.     

The effect of secretin and cholecystokinin-pancreozymin on the secretion of bile in the anaesthetized rabbit.

Effects of secretin and Cholecystokinin-Pancreozymin (CCK-PZ) on the secretion of bile in anaesthetized rabbits have been studied. Single injections of secretin (5.0 u.kg(-1) significantly increased the flow of bile irrespectively of whether the cystic duct was free or had been tied. A sustained increase in bile flow could be obtained by the continuous infusion of secretin. Cholecystokinin-Pancreozymin was effective in increasing the bile flow in doses of 1.0 u.kg(-1). Much of the effect could be attributed to contraction of the gallbladder but a significant increase in flow could still be elicited after ligation of the cystic duct. Our findings strongly suggest that the biliary secretion in rabbits is not as different from the general pattern as has previously been suggested.     

Orlistat reduces gallbladder emptying by inhibition of CCK release in response to a test meal

BACKGROUND AND AIMS: Orlistat is a covalent inhibitor of digestive lipase derived from lipstatin, the natural product of Streptomyces toxytricini. By blocking the active site of intestinal lipase, orlistat inhibits hydrolysis of dietary triglycerides and thus reduces the intestinal lipid absorption. It is uncertain whether intestinal inhibition of lipase by orlistat also interferes with nutrient-induced CCK release from intestinal I-cells. The aim of the present study was therefore to assess whether oral administration of orlistat inhibits CCK release in response to a test meal and thus causes impaired gallbladder emptying. METHODS: 22 healthy volunteers were given a test meal consisting of 200 ml dairy cream and two teaspoons of chocolate powder (552 kcal=2328 kJ; 56.0 g fat; 5.2 g proteins, 6.6 g carbohydrates), with and without oral application of 120 mg orlistat. Gallbladder volume was determined by ultrasound before and 5, 10, 20, 30 and 40 min after meal ingestion. In parallel, a venous blood sample was collected for the measurement of bioactive CCK. CCK activity was assessed using a bioassay with isolated rat pancreatic acini cells. RESULTS: Oral administration of orlistat significantly impairs gallbladder emptying. After ingestion of the test meal the gallbladder contracted by 78.5% in the control group, whereas the test group with orlistat only showed a contraction of 45.7% (p<0.01). Maximal contraction was reached after 35 to 40 min, the maximal gallbladder emptying was delayed up to 10 min by orlistat. Orlistat induced a significant reduction of bioactive CCK levels in response to a test meal (CCK(max) with orlistat=4.1 pmol/l; CCK(max) without orlistat=7.8 pmol/l). CCK levels were reduced by 47% and the onset of maximal CCK secretion was delayed up to 10 min. CONCLUSION: The inhibition of intestinal lipolytic activity by orlistat results in reduced gallbladder emptying through inhibition of meal-mediated CCK release. We therefore hypothesize that impaired gallbladder motility may represent a risk factor in chronic treatment of severe obesity using orlistat.     

Identification of a hormonal basis for gallbladder filling

The cycle of gallbladder filling and emptying controls the flow of bile into the intestine for digestion. Here we show that fibroblast growth factor-15, a hormone made by the distal small intestine in response to bile acids, is required for gallbladder filling. These studies demonstrate that gallbladder filling is actively regulated by an endocrine pathway and suggest a postprandial timing mechanism that controls gallbladder motility.     

Effects of bile acids on the muscle functions of guinea pig gallbladder

Hydrophobic bile acids impair gallbladder emptying in vivo and inhibit gallbladder muscle contraction in response to CCK-8 in vitro. This study was aimed at determining the mechanisms of muscle cell dysfunction caused by bile acids in guinea pig gallbladders. Muscle cells were obtained by enzymatic digestion. Taurochenodeoxycholic acid (TCDC), a hydrophobic bile acid, caused a contraction of up to 15% and blocked CCK-induced contraction. Indomethacin abolished the TCDC-induced contraction. Hydrophilic bile acid tauroursodeoxycholic acid (TUDC) had no effect on muscle contraction but prevented the TCDC-induced contraction and its inhibition on CCK-induced contraction. Pretreatment with NADPH oxidase inhibitor PH2I, xanthine oxidase inhibitor allopurinol, and free-radical scavenger catalase also prevented TCDC-induced contraction and its inhibition of the CCK-induced contraction. TCDC caused H2O2 production, lipid peroxidation, and increased PGE2 synthesis and activities of catalase and SOD. These changes were significantly inhibited by pretreatment of PH2I or allopurinol. Inhibitors of cytosolic phospholipase A2 (cPLA2), protein kinase C (PKC), and mitogen-activating protein kinase (MAPK) also blocked the TCDC-induced contraction. It is concluded that hydrophobic bile acids cause muscle cell dysfunction by stimulating the formation of H2O2 via activation of NADPH and xanthine oxidase. H2O2 causes lipid peroxidation and activates cPLA2 to increase PGE2 production, which, in turn, stimulates the synthesis of free-radical scavengers through the PKC-MAPK pathway.     

Pathogenesis of human cholesterol cholelithiasis.

The pathogenesis of cholesterol cholelithiasis in humans has been studied by means of three techniques. The cholesterol-solubilizing capacity of bile may be determined by estimation of the relative composition of the three major lipid constituents of bile. Consistent reduction in the cholesterol-carrying capacity of gallbladder bile of persons with gallstones when compared with normal subjects has not been shown. Normal subjects frequently have supersaturated bile. Secretion rates of biliary lipids have been estimated by two methods; with the method that appears to be more physiologic no change in lipid secretion rates was found in gallstone patients. Bile acid pool size has been measured by isotope dilution techniques; it is reduced in patients with gallstones. It is not clear whether this reduction is important in the pathogenesis of cholesterol cholelithiasis, for the bile acid secretion rate is normal because of an increased rate of cycling of the pool through the enterohepatic circulation. The role of the gallbladder in the genesis of cholesterol cholelithiasis may be more important than has been realized.     

Mucin secretion by the human colon cell line LS174T is regulated by bile salts

We recently reported that bile salts play a role in the regulation of mucin secretion by cultured dog gallbladder epithelial cells. In this study we have examined whether bile salts also influence mucin secretion by the human epithelial colon cell line LS174T. Solutions of bile salts were applied to monolayers of LS174T cells. Mucin secretion was quantified by measuring the secretion of [3H]GlcNAc labeled glycoproteins. Both unconjugated bile salts as well as taurine conjugated bile salts stimulated mucin secretion by the colon cells in a dose-dependent fashion. Hydrophobic bile salts were more potent stimulators than hydrophilic bile salts. Free (unconjugated) bile salts were more stimulatory compared with their taurine conjugated counterparts. Stimulation of mucin secretion by LS174T cells was found to occur at much lower bile salt concentrations than in the experiments with the dog gallbladder epithelial cells. The protein kinase C activators PMA and PDB had no stimulatory effect on mucin secretion. We conclude that mucin secretion by the human colon epithelial cell line LS174T is regulated by bile salts. We suggest that regulation of mucin secretion by bile salts might be a common mechanism, by which different epithelia protect themselves against the detergent action of bile salts, to which they are exposed throughout the gastrointestinal tract.      

The rheology of pig small intestinal and colonic mucus: weakening of gel structure by non-mucin components.

Mechanical spectroscopy has been used to study the structure and properties of pig small intestinal and colonic adherent mucus gel. Both mucus secretions had properties of viscoelastic gels, but that from the small intestine was substantially weaker in quality. Small intestinal mucus gel was disrupted by acid (pH 1), detergents (bile) and protein denaturants while that from the colon remained stable following these treatments. Concentration of purified colonic mucin produced a gel with the same rheological properties as the native secretion. Purified small intestinal mucin when concentrated produced a stronger gel than the native secretion and, in contrast to the latter, one which was not disrupted by acid or denaturants. The instability of native small intestinal mucus was shown not to be a function of the mucin components (which alone could account for the gel-forming properties), but to arise from the presence of insoluble material largely from sloughed mucosal cells. These studies show (1) that mucus gels from the colon and small intestine have similar mechanical behaviour and properties to those from the stomach and duodenum, and (2) emphasise the caution that should be exercised when interpreting the rheological properties of mucus preparations, particularly with respect to their content of mucosal cellular material.     

Biliary response to food in chickens with intact or interrupted enterohepatic circulation

The biliary secretion in response to food has been studied in chicken. In this species, a well defined biliary postprandial response with a clear vesicular component can be estimated. The bile salt independent fraction increases after feeding. Our results show that gallbladder bile has a lower osmotic power. The biliary response to food when the enterohepatic circulation is blocked, diminishes. The relationship between bile salt independent fraction values, whether the vesicular duct is tied or not, remains constant when the enterohepatic circulation is interrupted.     

Interactions between bile and pancreatic juice diversions on cholecystokinin release and pancreas in conscious rats

Pancreatic exocrine secretion in the conscious rat is regulated by proteases secreted by the pancreas, and cholecystokinin (CCK) is known to be involved in its mechanism. It has also been reported that the absence of either pancreatic juice or bile in the duodenum could stimulate pancreatic secretion. Therefore, differences in CCK release responding to the exclusion of bile, pancreatic juice (PJ), or both bile and pancreatic juice (BPJ) from the intestine were examined by using a bioassay for cholecystokinin. Plasma CCK levels were increased by all three treatments compared with the basal value, the order of their effects being BPJ greater than PJ greater than bile diversion, and CCK concentrations produced by BPJ diversion were much greater than can be explained as simply summed effect of exclusions of bile and PJ. Pancreatic exocrine secretions were significantly increased by PJ and BPJ diversions, but the effect of bile diversion on the pancreas was not statistically significant. An additional infusion of CR-1409 (0.1 mg/rat), one of CCK receptor antagonists, inhibited exocrine function stimulated by BPJ diversion. We conclude (i) BPJ diversion is the strongest endogenous stimulant on CCK release; (ii) the potentiation between bile and PJ diversions is induced on CCK release; (iii) pancreatic protein secretion during BPJ diversion is mainly modulated by CCK.     

Presence of cholesterol ester synthetase activity in guinea pig gallbladder epithelium.

This study is the first to demonstrate the presence of cholesteryl ester synthetase activity in the gallbladder epithelium. Using epithelium of the guinea pig gallbladder, the study demonstrated that the enzyme was localized mainly in the particulate fraction. The enzyme required CoA and ATP for activity and displayed a pH optimum of 7.0. The uptake of biliary cholesterol by gallbladder (shown by other investigators) and the presence of cholesteryl ester synthetase activity (demonstrated in this study) suggest that the gallbladder epithelium has an active role which might be important in conditions of cholesterol supersaturation in bile.     

Structure and histochemical characteristics of the mucosa of the Vater's ampulla in man (according to materials of aimed biopsies)]

Examination of 52 aimed duodenal biopsies has revealed that there are several variants of the structure of the Vater's papilla mucous membrane. In a number of cases it is identicalto the mucous membrane of the duodenum. In 20 cases the Vater's papilla was covered with mucoid epithelium which was histochemically similar to the epithelium lining the stomach, bile ducts and the gallbladder. The "intermedial" forms found in these cases appearedto be capable to change into mucoid or edging epithelium. The mucous cells occasionally found in the Vater's papilla epithelium might be a variation of goblet cells. It seems that they are secreting by holocrine type.