Original Articles
Copyright ©The Author(s) 2001. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 15, 2001; 7(2): 203-207
Published online Apr 15, 2001. doi: 10.3748/wjg.v7.i2.203
Mucin and phospholipids determine viscosity of gallbladder bile in patients with gallstones
Dieter Jüngst, Anna Niemeyer, Iris Müller, Benedikta Zündt, Günther Meyer, Martin Wilhelmi, Reginald del Pozo
Dieter Jüngst, Anna Niemeyer, Iris Müller, Benedikta Zündt, Günther Meyer, Martin Wilhelmi, Reginald del Pozo, Departments of Medicine II and Surgery, Klinikum Grosshadern, Ludwig Maximilians-University Munich, Munich, Germany and Facultad de Medicina, Universidad Católica de la Santìsima Concepción, Concepción, Chile
Dieter Jüngst, graduated from the University of Munich as M.D. and is an associate professor of medicine with special interest in biliary diseases.
Author contributions: All authors contributed equally to the work.
Supported by the Else Kr-ner-Fresenius-Foundation, Bad Homburg v.d.H., Germany.
Correspondence to: Dieter Jüngst, M.D., Department of Medicine II, Klinikum Grosshadern, Marchioninistr. 15, 81377 Munich, Germany
Telephone: 01149-89-7095-2376 Fax: 01149-89-7095-5374
Received: February 6, 2001
Revised: February 23, 2001
Accepted: March 1, 2001
Published online: April 15, 2001
Abstract

AIM: An increased viscosity of gallbladder bile has been considered an important factor in the pathogenesis of gallstone disease. Besides lipids and proteins, mucin has been suggested to affect the viscosity of bile. To further clarify these issues we compared mucin, protein and the lipid componEnts of hepatic and gallbladder bile and its viscosity in patients with gallstones.

METHODS: Viscosity of bile (mPa.s) was measured using rotation viscosimetry in regard to the non Newtonian property of bile at low shear rates.

RESULTS: Biliary viscosity was markedly higher in gallbladder bile of patients with cholesterol (5.00 ± 0.60 mPa.s, mean ± SEM, n = 28) and mixed stones (3.50 ± 0.68 mPa.s; n = 8) compared to hepatic bile (0.92 ± 0.06 mPa.s, n = 6). A positive correlation between mucin and viscosity was found in gallbladder biles (r = 0. 65; P < 0.001) but not in hepatic biles. The addition of physiologic and supraphysiologic amounts of mucin to gallbladder bile resulted in a dose dependent non linear increase of its viscosity. A positive correlation was determined between phospholipid concentration and viscosity (r = 0.34, P < 0.005) in gallbladder biles. However, no correlation was found between total protein or the other lipid concentrations and viscosity in both gallbladder and hepatic biles.

CONCLUSION: The viscosity of gallbladder bile is markedly higher than that of hepatic bile in patients with gallstones. The concentration of mucin is the major determinant of biliary viscosity and may contribute by this mechanism to the role of mucin in the pathogenesis of gallstones.

Keywords: phospholipids/physiology; phospholipids/analysis; mucins/physiology; mucins/analysis; cholelithiasis/ etiology; viscosity; bile/chemistry