Binder H J, Rawlins C L
J Clin Invest. 1973 Jun;52(6):1460-6. doi: 10.1172/JCI107320.
The mechanism by which excess quantities of bile salts in the colon produce diarrhea is not known. Therefore, experiments were performed in which the effect of conjugated dihydroxy bile salts on ion transport was evaluated in the in vitro short-circuited rat colon. 2 mM glycochenodeoxycholic acid (GCDC), taurochenodeoxycholic acid (TCDC), or taurodeoxycholic acid caused a prompt increase in short-circuit current (I(sc)) and electrical potential difference (PD). Similar results were obtained when theophylline was added. Removal of HCO(2) and C1 prevented the effects of both bile salts and theophylline. Pretreatment with theophylline blocked the increase in I(sc) and PD produced by TCDC and pretreatment with either TCDC or GCDC inhibited the expected theophylline response. Na fluxes in the presence of both TCDC and theophylline demonstrated a decrease in net absorption; and TCDC decreased net C1 absorption and theophylline caused a reversal of net C1 absorption to net C1 secretion. It is proposed that the diarrhea associated with cholerheic enteropathy is produced by active anion secretion possibly mediated by cyclic AMP.
结肠中过量胆盐导致腹泻的机制尚不清楚。因此,我们进行了实验,在体外短路大鼠结肠中评估结合二羟基胆盐对离子转运的影响。2 mM甘氨鹅去氧胆酸(GCDC)、牛磺鹅去氧胆酸(TCDC)或牛磺脱氧胆酸可使短路电流(I(sc))和电势差(PD)迅速增加。添加茶碱时也得到了类似结果。去除HCO(2)和C1可阻止胆盐和茶碱的作用。用茶碱预处理可阻断TCDC引起的I(sc)和PD增加,用TCDC或GCDC预处理可抑制预期的茶碱反应。在TCDC和茶碱同时存在的情况下,Na通量显示净吸收减少;TCDC降低净C1吸收,茶碱使净C1吸收逆转至净C1分泌。有人提出,胆汁性肠病相关的腹泻可能是由环磷酸腺苷介导的活性阴离子分泌引起的。