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乙炔雌二醇诱导的胆汁淤积中胆汁碳酸氢盐分泌的抑制与大鼠中氯离子/碳酸氢根离子交换体活性受损无关。

Inhibition of biliary bicarbonate secretion in ethinyl estradiol-induced cholestasis is not associated with impaired activity of the Cl-/HCO-3 exchanger in the rat.

作者信息

Alvaro D, Gigliozzi A, Piat C, Carli L, Fraioli F, Romeo R, Francia C, Attili A F, Capocaccia L

机构信息

II Department of Gastroenterology, University of Rome, La Sapienza, Italy.

出版信息

J Hepatol. 1997 Jan;26(1):146-57. doi: 10.1016/s0168-8278(97)80021-9.

Abstract

BACKGROUND/AIMS: Bicarbonate is a major component of bile salt independent bile flow, which is impaired in ethinyl estradiol (EE)-cholestasis. To examine this subject in EE-cholestasis, we studied: 1) basal and glucagon-stimulated biliary bicarbonate secretion both in vivo and in the isolated perfused rat liver (IPRL); 2) H+/HCO-3 transport processes in isolated rat hepatocyte couplets.

METHODS

Rats received EE (5 mg.kg b.w.-1) for 5 days. Intracellular pH (pHi) was measured (BCECF-AM) using a single-cell microfluorimetric setup.

RESULTS

Bile flow was markedly (p < 0.01) decreased in EE-treated rats. Bicarbonate concentration in bile was decreased (p < 0.01) and bicarbonate secretion was 2.5-fold lower in EE-treated animals than in controls, both in bile-fistula rats [19.5 +/- 5.1 (n = 23) vs 54.2 +/- 5.7 (n = 20) nmol.min-1g liver-1; p < 0.01] and in the IPRL [11 +/- 2 (n = 8) vs 24 +/- 3 (n = 8) nmol.min-1.g liver-1; p < 0.01]. In control IPRL, a bile/perfusate gradient for bicarbonate is maintained, while it is lost in EE-treated IPRL because of the lower bicarbonate concentration in bile. Glucagon stimulated bile flow and bicarbonate secretion to a similar extent in EE-treated and control IPRL (+25% vs +23%). Resting pHi of EE-treated hepatocyte couplets was higher in comparison with controls in KRB [7.25 +/- 0.07 (n = 35) vs 7.20 +/- 0.05 (n = 33); p < 0.02] but similar in Hepes [7.08 +/- 0.07 (n = 24) vs 7.05 +/- 0.06 (n = 26)]. Basal activity of the Cl-/HCO-3 exchanger was similar in EE-treated and control hepatocyte couplets [H+ flux = 2.87 +/- 1.12 (n = 18) vs 3.01 +/- 1.23 mM/min (n = 15)] and was stimulated to a similar extent by glucagon. Na+/HCO3-symport activity was increased in EE-treated hepatocyte couplets (p < 0.05) while the Na+/H+ exchanger was unchanged.

CONCLUSIONS

Bicarbonate biliary secretion is markedly impaired during EE-cholestasis in association with a marked decrease of bile salt independent bile flow. However, the Cl-/HCO-3 exchanger and its hormonal regulation are normal, indicating that the lower bicarbonate excretion in EE-cholestasis is not due to a compromised activity of this anion exchanger. Since the bile/perfusate gradient for bicarbonate is dissipated in EE-treated IPRL, the impaired bicarbonate excretion could be caused by a reflux of biliary bicarbonate via leaky tight junctions.

摘要

背景/目的:碳酸氢盐是不依赖胆盐的胆汁流的主要成分,在乙炔雌二醇(EE)性胆汁淤积中该胆汁流受损。为了研究EE性胆汁淤积中的这一问题,我们进行了以下研究:1)在体内和离体灌注大鼠肝脏(IPRL)中检测基础状态及胰高血糖素刺激后的胆汁碳酸氢盐分泌;2)在分离的大鼠肝细胞膜偶联物中检测H⁺/HCO₃⁻转运过程。

方法

大鼠接受EE(5mg·kg体重⁻¹)处理5天。使用单细胞显微荧光测定装置测量细胞内pH(pHi)(用BCECF-AM)。

结果

EE处理的大鼠胆汁流量显著降低(p<0.01)。胆汁中碳酸氢盐浓度降低(p<0.01),EE处理组动物的碳酸氢盐分泌比对照组低2.5倍,无论是在胆瘘大鼠中[19.5±5.1(n=23)对54.2±5.7(n=20)nmol·min⁻¹·g肝脏⁻¹;p<0.01]还是在IPRL中[11±2(n=8)对24±3(n=8)nmol·min⁻¹·g肝脏⁻¹;p<0.01]。在对照IPRL中,维持了胆汁/灌注液之间的碳酸氢盐梯度,而在EE处理的IPRL中该梯度消失,因为胆汁中碳酸氢盐浓度较低。在EE处理组和对照组的IPRL中,胰高血糖素对胆汁流量和碳酸氢盐分泌的刺激程度相似(分别增加25%和23%)。与对照组相比,EE处理的肝细胞膜偶联物的静息pHi在KRB中较高[7.25±0.07(n=35)对7.20±0.05(n=33);p<0.02],但在Hepes中相似[7.08±0.07(n=24)对7.05±0.06(n=26)]。EE处理组和对照组肝细胞膜偶联物中Cl⁻/HCO₃⁻交换体的基础活性相似[H⁺通量=2.87±1.12(n=18)对3.01±1.23mM/min(n=15)],且胰高血糖素对其刺激程度相似。EE处理的肝细胞膜偶联物中Na⁺/HCO₃协同转运体活性增加(p<0.05),而Na⁺/H⁺交换体未改变。

结论

在EE性胆汁淤积期间,胆汁中碳酸氢盐分泌显著受损,同时不依赖胆盐的胆汁流显著减少。然而,Cl⁻/HCO₃交换体及其激素调节是正常的,这表明EE性胆汁淤积中较低的碳酸氢盐排泄并非由于该阴离子交换体活性受损。由于在EE处理的IPRL中胆汁/灌注液之间的碳酸氢盐梯度消失,碳酸氢盐排泄受损可能是由于胆小管紧密连接渗漏导致胆汁中碳酸氢盐反流所致。

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