Accatino L, Figueroa C, Pizarro M, Solís N
Departamento de Gastroenterologia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile.
J Hepatol. 1995 Jun;22(6):658-70. doi: 10.1016/0168-8278(95)80221-5.
BACKGROUNDS/AIMS: Canalicular membrane enzymes are normally released into bile by partially known processes. This study was undertaken to investigate whether hepatocellular cholestatis induced in rats by ethynylestradiol or obstructive cholestasis produced by complete biliary obstruction for 24 h is associated with an increased release of alkaline phosphatase and gamma-glutamyl transpeptidase into bile, and to clarify how this process is affected by different bile acids.
The studies were performed in the isolated perfused liver during infusion of sodium taurocholate, taurochenodeoxycholate and tauroursodeoxycholate at increasing rates.
Maximum sodium taurocholate, taurochenodeoxycholate and tauroursodeoxycholate secretory rates were decreased in both cholestatic groups (complete biliary obstruction > ethynylestradiol) compared with controls. Maximum biliary outputs of alkaline phosphatase and gamma-glutamyl transpeptidase were significantly increased in the ethynylestradiol group during infusion of sodium taurocholate and taurochenodeoxycholate, but not of tauroursodeoxycholate, and were increased in the complete biliary obstruction group during the infusion of sodium taurocholate and tauroursodeoxycholate but not of taurochenodeoxycholate. The biliary outputs of alkaline phosphatase and gamma-glutamyl transpeptidase showed a significant and direct linear relationship with sodium taurocholate and taurochenodeoxycholate secretory rates in both cholestatic groups. However, only in the complete biliary obstruction group did alkaline phosphatase and gamma-glutamyl transpeptidase excretion show a significant correlation with tauroursodeoxycholate secretory rates. The slope of the line, which indicated the mU of enzyme activity secreted per nmol of sodium taurocholate or taurochenodeoxycholate, was greater for gamma-glutamyl transpeptidase and alkaline phosphatase in both cholestatic groups (ethynylestradiol > complete biliary obstruction) than in the control group. Alkaline phosphatase activity in purified isolated canalicular and sinusoidal membranes was significantly increased in both cholestatic groups (complete biliary obstruction > ethynylestradiol), while gamma-glutamyl transpeptidase activity was unchanged compared with controls.
The marked increase in sodium taurocholate and taurochenodeoxycholate-mediated release of alkaline phosphatase and gamma-glutamyl transpeptidase into bile in cholestatic rats suggests an increased lability of these intrinsic membrane proteins to the detergent effects of secreted bile acids. It remains to be elucidated whether this phenomenon, which was particularly intense in ethynylestradiol induced cholestasis, is important in the pathogenesis and perpetuation of bile secretory failure. In contrast, tauroursodeoxycholate administration did not result in enhanced biliary excretion of these membrane enzymes, in either the control group or the ethynylestradiol group, supporting the concept that this bile salt lacks the membrane toxicity of common bile acids.
背景/目的:胆小管膜酶通常通过部分已知过程释放到胆汁中。本研究旨在调查乙炔雌二醇诱导的大鼠肝细胞性胆汁淤积或完全性胆管梗阻24小时产生的梗阻性胆汁淤积是否与碱性磷酸酶和γ-谷氨酰转肽酶向胆汁中的释放增加有关,并阐明该过程如何受到不同胆汁酸的影响。
在灌注牛磺胆酸钠、牛磺鹅去氧胆酸和牛磺熊去氧胆酸速率递增的情况下,对离体灌注肝脏进行研究。
与对照组相比,两个胆汁淤积组(完全性胆管梗阻>乙炔雌二醇)中牛磺胆酸钠、牛磺鹅去氧胆酸和牛磺熊去氧胆酸的最大分泌速率均降低。在灌注牛磺胆酸钠和牛磺鹅去氧胆酸期间,乙炔雌二醇组中碱性磷酸酶和γ-谷氨酰转肽酶的最大胆汁输出量显著增加,但灌注牛磺熊去氧胆酸时未增加;在灌注牛磺胆酸钠和牛磺熊去氧胆酸期间,完全性胆管梗阻组中碱性磷酸酶和γ-谷氨酰转肽酶的最大胆汁输出量增加,但灌注牛磺鹅去氧胆酸时未增加。在两个胆汁淤积组中,碱性磷酸酶和γ-谷氨酰转肽酶的胆汁输出量与牛磺胆酸钠和牛磺鹅去氧胆酸的分泌速率呈显著的直接线性关系。然而,仅在完全性胆管梗阻组中,碱性磷酸酶和γ-谷氨酰转肽酶的排泄与牛磺熊去氧胆酸的分泌速率呈显著相关性。表示每纳摩尔牛磺胆酸钠或牛磺鹅去氧胆酸分泌的酶活性毫单位的直线斜率,在两个胆汁淤积组(乙炔雌二醇>完全性胆管梗阻)中,γ-谷氨酰转肽酶和碱性磷酸酶均大于对照组。在两个胆汁淤积组(完全性胆管梗阻>乙炔雌二醇)中,纯化的离体胆小管和窦状隙膜中的碱性磷酸酶活性显著增加,而γ-谷氨酰转肽酶活性与对照组相比未改变。
胆汁淤积大鼠中牛磺胆酸钠和牛磺鹅去氧胆酸介导的碱性磷酸酶和γ-谷氨酰转肽酶向胆汁中的释放显著增加,表明这些内在膜蛋白对分泌型胆汁酸的去污剂作用的稳定性增加。在乙炔雌二醇诱导的胆汁淤积中尤为强烈的这一现象在胆汁分泌衰竭的发病机制和持续存在中是否重要仍有待阐明。相比之下,在对照组或乙炔雌二醇组中,给予牛磺熊去氧胆酸均未导致这些膜酶的胆汁排泄增加,支持了这种胆汁盐缺乏常见胆汁酸的膜毒性这一观点。