In vitro inhibition of platelet aggregation by bile salts.

In a series of in vitro experiments, the influence of bile salts on platelet aggregation by ADP or by collagen and on serotonin-14C release by collagen, was studied. Sodium salts of the following bile acids showed a clear inhibitory effect: glycochenodeoxycholic acid, taurochenodeoxycholic acid, glycocholic acid, taurocholic acid and cholic acid. Lowering the pH of the platelet-rich plasma resulted in decrease platelet aggregation by ADP and by collagen. Bile salts further enhanced the inhibitory effect of pH change. In contrast the sodium salt of chenodeoxycholic acid was the sole aggregation inducing bile salt we studied. Relating the above studies to the clinical situation of upper gastroduodenal mucosal haemorrhage, we suggest that biliary reflux as well as the acidic environment may contribute to a poor haemostatic response by impaired platelet aggregation in the upper gastrointestinal tract of otherwise normal human subjects.