RESUMEN
Rat brain ethanolaminephosphotransferase (CDPethanolamine : 1,2-diacylglycerol ethanolaminephosphotransferase, EC 2.7.8.1) was solubilized by treating rat brain microsomes with buffered solutions containing octyl glucoside or Triton X-100. The solubilized enzyme was stable both at 4 degrees C and at -18 degrees C. A partial purification was obtained using an ion-exchange chromatographic procedure. The partially purified enzyme showed four major bands in SDS-polyacrylamide gel electrophoresis; its specific activity was increased by a factor of 37 compared to that of the membrane-bound enzyme. Glycerol and diacylglycerol were effective as stabilizers. Phosphatidylcholine, lysophosphatidylcholine and phosphatidylserine increased both the specific activity and the stability of the partially purified enzyme.
Asunto(s)
Encéfalo/ultraestructura , Etanolaminofosfotransferasa/aislamiento & purificación , Microsomas/enzimología , Fosfotransferasas/aislamiento & purificación , Animales , Encéfalo/enzimología , Cromatografía por Intercambio Iónico , Electroforesis en Gel de Poliacrilamida , Glucósidos , Glicerol/farmacología , Cinética , Octoxinol , Fosfolípidos/farmacología , Polietilenglicoles , Ratas , SolubilidadRESUMEN
The incorporation of CMP into CDP-ethanolamine and CDP-choline, catalyzed by ethanolaminephosphotransferase (EC 2.7.8.1) and cholinephosphotransferase (EC 2.7.8.2), respectively, has been studied in solubilized preparations of rat-brain microsomes. Mn2+ ions were required for the maximal activity of both enzymes. The CMP concentration needed to reach the half-maximal reaction rate was 1.6 microM for both activities. The rate of incorporation of CMP into CDP-choline and CDP-ethanolamine was increased by increasing the concentration of phosphatidylcholine and phosphatidylethanolamine, respectively, in detergent-phospholipid micellar systems. The rate of the reaction at pH 6.5 was comparable with that measured at pH 8.5, whereas the rate of synthesis of phosphatidylcholine and phosphatidylethanolamine, catalyzed by the same enzymes, increased with pH. Ethanolaminephosphotransferase, which catalyzes the synthesis of phosphatidylethanolamine from CDP-ethanolamine and diacylglycerol, was co-eluted with the enzyme activity catalyzing the reverse reaction, when solubilized microsomes were submitted to anion exchange chromatography on DEAE Bio-Gel A. Cholinephosphotransferase was inactivated during the chromatographic procedure.
Asunto(s)
Encéfalo/enzimología , Diacilglicerol Colinafosfotransferasa/metabolismo , Etanolaminofosfotransferasa/metabolismo , Microsomas/enzimología , Animales , Catálisis , Colina/metabolismo , Cromatografía por Intercambio Iónico , Diacilglicerol Colinafosfotransferasa/aislamiento & purificación , Etanolamina , Etanolaminofosfotransferasa/aislamiento & purificación , Etanolaminas/metabolismo , Concentración de Iones de Hidrógeno , Técnicas In Vitro , Ratas , SolubilidadRESUMEN
Ethanolaminephosphotransferase (CDPethanolamine:1,2-diacylglycerol ethanolaminephosphotransferase, EC 2.7.8.1) has been purified in active form from rat brain microsomes by a two-step chromatographic procedure. Enzyme preparations characterized by high specific activity and stability were obtained supplementing the solubilization and elution buffers, containing 1% Triton X-100, with 0.01% 2,6-di-tert-butyl-4-methylphenol. The specific activity of the purified enzyme was about 1200-times higher than that of the crude solubilized enzyme. The lipid dependence of ethanolaminephosphotransferase was studied both in the presence of Triton X-100 and in detergent-free enzyme preparations. The activity of the detergent-solubilized ethanolaminephosphotransferase was strongly modified by phospholipids. The kinetic behaviour of the enzyme was also dependent on the lipids contained in the aggregates obtained by removal of the detergent from detergent/lipid/protein suspensions. A regulatory role of phospholipids on the activity of the membrane-bound ethanolaminephosphotransferase is discussed.
Asunto(s)
Etanolaminofosfotransferasa/aislamiento & purificación , Lípidos de la Membrana/fisiología , Fosfotransferasas/aislamiento & purificación , Animales , Encéfalo/enzimología , Cromatografía Liquida/métodos , Electroforesis en Gel de Poliacrilamida , Estabilidad de Enzimas , Etanolaminofosfotransferasa/metabolismo , Cinética , Microsomas/enzimología , Octoxinol , Polietilenglicoles , Ratas , SolubilidadRESUMEN
The compartmentation of membrane phosphatidylethanolamine (PE) formed by base-exchange reaction in rat brain microsomal vesicles has been investigated. After labelling membrane PE by base-exchange in vitro, microsomal vesicles were treated with trinitrobenzenesulfonic acid (TNBS). The amount of membrane PE reacting with TNBS depends on the duration and the temperature of the reaction as well as on the TNBS concentration. It was found that almost all of the labelled PE molecules, but only about 24% of membrane PE, were accessible to TNBS, under very mild reaction conditions. It is concluded that PE labelled by base-exchange is completely localized in the cytoplasmic leaflet of microsomal vesicles.
Asunto(s)
Encéfalo/metabolismo , Lípidos de la Membrana/metabolismo , Fosfatidiletanolaminas/metabolismo , Animales , Compartimento Celular , Fenómenos Químicos , Química , Membranas Intracelulares/metabolismo , Masculino , Microsomas/metabolismo , Ratas , Ratas Endogámicas , Factores de Tiempo , Ácido TrinitrobencenosulfónicoRESUMEN
The transbilayer fatty acid distribution of diacylglycerophosphoethanolamine and the translocation of newly synthesized phosphatidylethanolamine molecules labelled with different fatty acids has been investigated in chick brain microsomes using trinitrobenzensulfonic acid. The determination of the fatty acid composition of diacylglycerophosphoethanolamine in both the outer and the inner leaflet of the microsomal vesicles revealed a similar distribution indicating that both leaflets share the same molecular species. The in vitro incorporation of radioactive fatty acids (16:0, 18:1 and 20:4(n-6] into ethanolamine phospholipids, known to be catalyzed by the lyosphosphatidylethanolamine acyl transferase, showed that the radioactive diacylglycerophosphoethanolamine molecules appeared first in the outer leaflet and were thereafter transferred to the inner leaflet. The apparent rate of translocation of the newly synthesized ethanolamine phospholipid molecules was the highest for those labelled with 16:0 and the lowest for those labelled with 20:4(n-6). The results indicate that the active site of the acyl-CoA:lysophosphatidylethanolamine acyltransferases is located on the outer leaflet of the microsomal vesicles and that the different newly synthesized molecular species of diacylglycerophosphoethanolamine may be translocated from the outer to the inner leaflet at different rates.
Asunto(s)
Encéfalo/metabolismo , Ácidos Grasos no Esterificados/metabolismo , Membrana Dobles de Lípidos , Microsomas/metabolismo , Fosfatidiletanolaminas/metabolismo , Animales , Radioisótopos de Carbono , Pollos , Membranas Intracelulares/metabolismo , Cinética , Fosfatidiletanolaminas/biosíntesis , Técnica de Dilución de RadioisótoposRESUMEN
CDP-ethanolamine:diacylglycerol ethanolaminephosphotransferase (EC 2. 7.8.1) has been purified to electrophoretic homogeneity and in a catalytically active form from bovine liver microsomes. The purification method is based on the high hydrophobicity of the protein whose charged sites appear to be masked from the interaction with the chromatographic stationary phases when membranes are solubilized with an excess of non-ionic detergent. The isolated protein has a molecular mass of about 38 kDa, as estimated by SDS-PAGE mobility, and exhibits both ethanolaminephosphotransferase and cholinephosphotransferase activities. Evidence is given that both activities are Mn2+-dependent and that the same catalytic site is involved in cholinephosphotransferase and ethanolaminephosphotransferase reactions. Mg2+-dependent CDP-choline:diacylglycerol cholinephosphotransferase (EC 2.7.8.2) is completely inactivated during the solubilization and purification steps.
Asunto(s)
Diacilglicerol Colinafosfotransferasa/aislamiento & purificación , Etanolaminofosfotransferasa/aislamiento & purificación , Microsomas Hepáticos/enzimología , Animales , Sitios de Unión , Unión Competitiva , Bovinos , Citidina Difosfato/análogos & derivados , Citidina Difosfato/metabolismo , Citidina Difosfato Colina/metabolismo , Detergentes , Diacilglicerol Colinafosfotransferasa/metabolismo , Activación Enzimática/efectos de los fármacos , Etanolaminofosfotransferasa/metabolismo , Etanolaminas/metabolismo , Concentración de Iones de Hidrógeno , Manganeso/farmacología , Peso Molecular , Polidocanol , Polietilenglicoles , SolubilidadRESUMEN
The 3ß-hydroxysterol Δ14-reductase, encoded by the Tm7sf2 gene, is an enzyme involved in cholesterol biosynthesis. Cholesterol and its derivatives control epidermal barrier integrity and are protective against environmental insults. To determine the role of the gene in skin cholesterol homeostasis, we applied 12-o-tetradecanoylphorbol-13-acetate (TPA) to the skin of Tm7sf2(+/+) and Tm7sf2(-/-) mice. TPA increased skin cholesterol levels by inducing de novo synthesis and up-take only in Tm7sf2(+/+) mouse, confirming that the gene maintains cholesterol homeostasis under stress conditions. Cholesterol sulfate, one of the major players in skin permeability, was doubled by TPA treatment in the skin of wild-type animals but this response was lost in Tm7sf2(-/-) mice. The expression of markers of epidermal differentiation concomitant with farnesoid-X-receptor and p38 MAPK activation were also disrupted in Tm7sf2(-/-) mice. We then subjected Tm7sf2(+/+) and Tm7sf2(-/-) mice to a classical two-stage skin carcinogenesis protocol. We found that the loss of Tm7sf2 increased incidence and multiplicity of skin papillomas. Interestingly, the null genotype showed reduced expression of nur77, a gene associated with resistance to neoplastic transformation. In conclusion, the loss of Tm7sf2 alters the expression of proteins involved in epidermal differentiation by reducing the levels of cholesterol sulfate.
Asunto(s)
Colesterol/biosíntesis , Oxidorreductasas/metabolismo , Neoplasias Cutáneas/genética , Piel/metabolismo , Animales , Carcinógenos , Diferenciación Celular/genética , Transformación Celular Neoplásica/genética , Colesterol/genética , Humanos , Ratones , Ratones Transgénicos , Oxidorreductasas/genética , Papiloma/patología , Papiloma/virología , Piel/patología , Piel/virología , Neoplasias Cutáneas/metabolismo , Neoplasias Cutáneas/patologíaRESUMEN
UNLABELLED: The purpose of this study was to determine whether patients at high risk for clinical restenosis, following coronary angioplasty, could be identified by myocardial perfusion imaging performed with dipyridamole- 82Rb PET. METHODS: Forty-five patients (34 men, 11 women; mean age 58.5 yr) who had successful single-vessel angioplasty and were asymptomatic had dipyridamole-82Rb PET at 1 and 3 mo after the procedure. Abnormal flow reserve in the distribution of the angioplasty artery on PET was considered to be a decrease of > or = 1 perfusion grade in response to dipyridamole (assessed qualitatively from tomographic images and polar coordinate maps). Follow-up was performed for 6 mo postangioplasty. Clinical restenosis was defined as recurrent angina similar to that occurring before angioplasty and/or > or = 50% stenosis at the angioplasty site documented angiographically. We analyzed abnormal flow reserve in the distribution of the angioplasty vessel to identify which patients were at high risk for clinical restenosis. RESULTS: Fourteen patients developed clinical restenosis between 1 and 6 mo postangioplasty. Abnormal relative flow reserve in the distribution of the angioplasty vessel was present prior to the development of symptoms in 13 of 14 patients with clinical restenosis and in 8 of 31 patients without clinical restenosis (sensitivity 93%, specificity 74%, p < 0.0001). PET imaging successfully separated postangioplasty patients into groups with high (62%) and low (4%) risk of clinical restenosis. CONCLUSION: Abnormal relative flow reserve in the distribution of the angioplasty vessel on dipyridamole PET identifies asymptomatic postangioplasty patients at risk for clinical restenosis.
Asunto(s)
Angioplastia Coronaria con Balón , Circulación Coronaria , Enfermedad Coronaria/diagnóstico por imagen , Dipiridamol , Radioisótopos de Rubidio , Tomografía Computarizada de Emisión , Enfermedad Coronaria/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
Patients with reduced left ventricular function or aneurysms have cavities that appear dark on SPECT thallium scintigrams. We hypothesized that a quantitative index, which relates thallium activity in the left ventricular cavity to that in the myocardium (C/M ratio), could provide information on left ventricular function. A group of 80 patients who had both exercise SPECT thallium imaging and cardiac catheterization were studied. The C/M ratio was obtained from the short-axis tomogram on both exercise and rest images. Counts in a 2 x 2 pixel region of interest in the left ventricular cavity were divided by the number of counts in the "hottest" area of the myocardium. Plotting the angiographically determined ejection fraction against the C/M exercise and rest ratios, we observed a linear correlation between ejection fraction and both C/M ratios, r = 0.65 for C/M exercise and r = 0.67 for C/M rest ratio (p < 0.00001). Using data from 12 normal cardiac catheterization patients, we established the lower limit of normal; 50% for ejection fraction and 0.40 for the C/M ratios. A C/M exercise ratio < or = 0.40 identified 26 of 31 patients with an ejection fraction < or = 50%. A C/M exercise ratio > 0.40 identified 39 of 49 patients with an ejection fraction > 50%. These calculations yielded a sensitivity of 83% and specificity of 78% for the C/M exercise ratio. A similar analysis for C/M rest ratio revealed sensitivity of 61% and specificity of 92%. The present study shows that an abnormal C/M ratio correctly distinguishes patients with abnormal from normal ejection fractions with an accuracy of 81%. The C/M ratio is easily obtained, requires minimal processing time and is highly reproducible. These attributes may enable this index to add supplementary information regarding left ventricular function in addition to perfusion from thallium imaging.
Asunto(s)
Corazón/diagnóstico por imagen , Radioisótopos de Talio , Tomografía Computarizada de Emisión de Fotón Único , Adulto , Anciano , Anciano de 80 o más Años , Cateterismo Cardíaco , Enfermedad Coronaria/diagnóstico por imagen , Enfermedad Coronaria/fisiopatología , Prueba de Esfuerzo , Femenino , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Volumen Sistólico , Función Ventricular IzquierdaRESUMEN
UNLABELLED: This study evaluated the ability of dipyridamole PET myocardial perfusion imaging to detect coronary collaterals. A previous study showed an association between dipyridamole-induced coronary steal on PET imaging and the presence of coronary collaterals on angiography. METHODS: Dipyridamole PET myocardial perfusion imaging using 82Rb was performed in 45 patients who had recent coronary angiography. The stress/rest count ratio (rubidium activity with stress divided by activity at rest)-was used to express the change in regional tracer uptake with dipyridamole and was calculated manually and automatically. The accuracy of the stress/rest count ratio for detecting coronary collaterals was determined. RESULTS: A manual stress/rest count ratio < or = 0.80 identified coronary collaterals with 81% sensitivity, 92% specificity and 90% accuracy (p < 0.0001). An automated ratio < or = 0.80 had 90% sensitivity, 88% specificity and 90% accuracy (p < 0.0001). Vascular beds incorrectly identified by PET as having collaterals had an increased frequency of severe stenoses and abnormal wall motion. CONCLUSION: PET perfusion imaging using the stress/rest count ratio can serve as a unique imaging method to identify coronary collaterals noninvasively.
Asunto(s)
Circulación Colateral , Circulación Coronaria , Vasos Coronarios/diagnóstico por imagen , Dipiridamol , Radioisótopos de Rubidio , Tomografía Computarizada de Emisión , Vasodilatadores , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y EspecificidadRESUMEN
Phospholipid metabolism in neuroblastoma cells in monolayer culture after acute exposure to pyridoxal phosphate (PLP) has been studied. (a) A strong depression of the rate of biosynthesis of cellular phospholipids from labeled choline and ethanolamine, is demonstrated in neuroblastoma cells grown in culture media containing PLP. (b) Valproic acid reverses the effect of PLP on ethanolamine and choline incorporation into cell lipid. Other anticonvulsants (clonazepam, diazepam, carbamazepine, diphenylhydantoin and ethosuximide) have little or no effect on reversing the inhibition of lipid synthesis produced by PLP. (c) PLP decreases the cellular uptake of choline. This effect might be responsible for the decreased lipid synthesis and is partially reversed by valproic acid. (d) The energy charge of the cell is not affected by either PLP or valproic acid, but it is diminished by the two compounds together. (e) The degradation of choline lipids is decreased by PLP and valproic acid. The hydrolysis of phosphocholine and the outflow of choline from cultured cells is also affected by the drugs. Variations of ethanolamine and choline transport should not be due to any effects of PLP or valproic acid on the lipid phase of the membranes since these molecules have no effect on the permeability of liposomes. (f) It is concluded that ethanolamine and choline lipid metabolism in cultured neuroblastoma cells is influenced by PLP and/or valproic acid, probably through a mechanism involving the transport of precursors across the membrane, although other mechanisms cannot be ruled out.
Asunto(s)
Fosfolípidos/metabolismo , Fosfato de Piridoxal/farmacología , Ácido Valproico/farmacología , Metabolismo Energético/efectos de los fármacos , Membrana Dobles de Lípidos/metabolismo , Neuroblastoma/metabolismo , Permeabilidad , Células Tumorales CultivadasRESUMEN
Transient dilatation of the left ventricular cavity on exercise thallium perfusion imaging is recognized as a marker of significant coronary disease, but the mechanisms that produce this finding are not fully understood. We studied 32 patients who underwent exercise thallium imaging and exercise echocardiography to determine the changes in left ventricular cavity size that underlie transient dilatation. Left ventricular area from the apical four-chamber view was used to approximate left ventricular cavity size. There were 24 patients who did not have transient dilatation (group 1) and 8 patients who did have transient dilatation (group 2) on thallium imaging. Systolic area decreased from rest to exercise in group 1 patients but not in group 2 patients. There was no significant change in diastolic area from rest to exercise in either group 1 or group 2 patients. Thus, exercise-induced systolic dysfunction, manifested as a failure to decrease left ventricular systolic cavity size in exercise, may be an important mechanism in producing scintigraphic transient dilatation.
Asunto(s)
Ecocardiografía , Prueba de Esfuerzo , Hipertrofia Ventricular Izquierda/diagnóstico por imagen , Radioisótopos de Talio , Tomografía Computarizada de Emisión de Fotón Único , Femenino , Humanos , Masculino , Persona de Mediana Edad , Función Ventricular IzquierdaRESUMEN
Seven female patients (age 27 to 53 yr) with significant mitral stenosis performed continuous, incremental, maximal treadmill exercise tests the day before and within 3-5 days after catheter-balloon valvuloplasty. Mitral valve area determined by the echo-Doppler method increased from 0.9 +/- 0.3 cm2 to 1.9 +/- 0.7 cm2 (p < 0.02). Mean left atrial pressure was reduced from 24 +/- 8 to 13 +/- 7 mmHg (p < 0.01) and mean pulmonary artery pressure from 36 +/- 13 to 28 +/- 10 mmHg (p < 0.02) with a non-significant increase in cardiac output from 3.6 +/- 1.2 to 4.0 +/- 1.7 l/min. After catheter-balloon valvuloplasty all patients reached a higher maximal workload during exercise, and mean value of oxygen consumption and pulmonary ventilation were significantly lower in submaximal workloads. The calculated ventilatory equivalent for oxygen was significantly reduced in submaximal and in maximal workloads after catheter-balloon valvuloplasty. Peak oxygen consumption and the ventilatory anaerobic threshold were not changed after catheter-balloon valvuloplasty (pre 15.59 +/- 2.72 vs post 16.90 +/- 3.44 and pre 12.10 +/- 2.55 vs post 12.62 +/- 2.71 ml/kg/min, respectively). We concluded that after catheter-balloon valvuloplasty the cost of breathing was reduced and the oxygen consumed was more effectively utilized during exercise. Increases in peak oxygen consumption and in ventilatory anaerobic threshold would require circulatory and metabolic adaptations in response to increased physical activity and were not observed when cardiopulmonary tests were performed early after catheter-balloon valvuloplasty.
Asunto(s)
Cateterismo , Prueba de Esfuerzo , Estenosis de la Válvula Mitral/terapia , Adulto , Insuficiencia de la Válvula Aórtica/fisiopatología , Ecocardiografía , Ecocardiografía Doppler , Femenino , Hemodinámica/fisiología , Humanos , Persona de Mediana Edad , Válvula Mitral/fisiopatología , Insuficiencia de la Válvula Mitral/fisiopatología , Estenosis de la Válvula Mitral/fisiopatología , Oxígeno/fisiologíaRESUMEN
The transfer of radioactivity from cytidine-5'-diphosphate ethanolamine into 1-alkyl-2-acyl-sn-glycerophosphorylethanolamine of neuronal and glial cells from adult rabbit brain cortex has been investigated in vitro. The synthesis of 1-alkyl-2-acyl-sn-glycerophosphorylethanolamine in both cell populations was stimulated 23-25-fold by the addition of 6 mM alkylacylglycerol. The neuronal cell-enriched fraction was found to possess/unit protein a 1.7-1.8-fold ethanolaminephosphotransferase activity (EC 2.7.8.1), as compared to the glial fraction, when saturating concentrations (6 mM) of alkylacylglycerols were added in the incubation system. The neuronal/glial ratio was 2.6-2.8 in the absence of lipid acceptor or with low concentrations of alkylacylglycerol. Under most favorable conditions, 6.4 and 3.3 nmoles 1-alkyl-2-acyl-sn-glycerophosphorylethanolamine/mg protein/30 min was obtained for neurons and glia, respectively. Various kinetic properties of the 1-alkyl-2-acyl-sn-glycerophosphorylethanolamine synthesizing phosphotransferase activity were found to be similar both in neurons and glia.
Asunto(s)
Corteza Cerebral/enzimología , Neuroglía/enzimología , Neuronas/enzimología , Fosfotransferasas/metabolismo , Animales , Cromatografía de Gases , Nucleótidos de Citosina/farmacología , Etanolaminas/farmacología , Glicéridos , Técnicas In Vitro , Cinética , Neuroglía/efectos de los fármacos , Neuronas/efectos de los fármacos , Fosfatidiletanolaminas/análogos & derivados , Fosfolípidos , Conejos , Factores de TiempoRESUMEN
Isolated peripheral arterial ischaemia (IPAI) is an unusual pathology of dialysis and peritoneal patients which represents the first sign of a complication of uraemia known as calciphylaxis. Recent studies have revealed an increased incidence of this complication. Risk factors are known but there is no consensus on them: elevated CaxP product, female gender, elevated serum parathormone. We present here the case of a 65-year-old man with 21-year history of dialysis, distal isolated ulceration and without any signs of severe vasculopathy. Our clinical diagnosis was calciphylaxis. In this case, the role of early PTX is not clear and the use of steroids is recommended only in non-ulcerating cases. The therapy gives good results but not in all patients. Electrical stimulation of the posterior roots of the spinal cord is an alternative approach to this case. We hypothesised that the electrical action, through cutaneous vasodilatation of afferent dorsal fibres and release of calcitonin gene-releasing protein, determines the release of prostaglandin E sub 2 that may positively affect the proliferation and activity of epidermal fibroblasts.
Asunto(s)
Calcifilaxia/etiología , Terapia por Estimulación Eléctrica , Isquemia/etiología , Enfermedades Vasculares Periféricas/etiología , Diálisis Renal/efectos adversos , Vías Aferentes/fisiopatología , Anciano , Antiinflamatorios/uso terapéutico , Calcifilaxia/terapia , Péptido Relacionado con Gen de Calcitonina/metabolismo , Terapia Combinada , Dexametasona/uso terapéutico , Dinoprostona/metabolismo , Fibroblastos/patología , Úlcera del Pie/tratamiento farmacológico , Úlcera del Pie/etiología , Úlcera del Pie/terapia , Humanos , Isquemia/terapia , Pierna/irrigación sanguínea , Plexo Lumbosacro , Masculino , Modelos Neurológicos , Enfermedades Vasculares Periféricas/terapia , Temperatura Cutánea , Raíces Nerviosas Espinales , VasodilataciónRESUMEN
To assess the potential structural changes of the biliary tree and liver in patients with extrahepatic biliary obstruction, the resected specimens of 20 patients operated for benign biliary stricture were evaluated by means of immunocytochemical and histological methods. Furthermore, liver biopsies were taken for the same purposes. The results showed that in the dilated segment of the hepatic duct proximal to the stricture, innervation was greatly reduced or completely absent with associated advanced morphological and histological changes and high intrabiliary pressure levels. Similar findings were observed in the liver biopsies, too. These biopsies showed advanced morphological and histological changes associated with reduced innervation. By contrast, the nondilated segment of the hepatic duct, distal to the obstruction, showed normal innervation, normal morphology and histology and normal levels of intrabiliary pressure. The present study provides evidence that in cases of extrahepatic biliary obstruction, there are advanced pathological changes in the biliary tree associated with innervation impairment. These structural changes are associated with functional changes in both the liver and the biliary tree. Such functional changes represent a threat to the patient, particularly if major surgery is required. Increased biliary pressure appears to be a major cause of the development of these changes. Biliary drainage, either surgical or endoscopic, is indicated as the only alternative to reduce intrabiliary pressure and to contribute to a reversal of these structural and functional changes.
Asunto(s)
Bilis/fisiología , Colelitiasis/fisiopatología , Colestasis Extrahepática/fisiopatología , Conducto Hepático Común/fisiopatología , Biopsia , Colelitiasis/patología , Colestasis Extrahepática/patología , Conducto Hepático Común/inervación , Conducto Hepático Común/patología , Humanos , PresiónRESUMEN
In this study the authors have investigated the different morphofunctional features of the gallbladder mucosa in patients with uncomplicated cholelithiasis. Histological changes, type and distribution of endocrine and mucin-producing cells were characterized by immunocytochemistry and mucin histochemistry. The authors attempted to correlate these findings to the number and size of gallbladder stones as well as type of bacteria present in the bile. The results indicate that, despite similar clinical parameters, a wide range of histological changes may occur in the gallbladder mucosa of these patients. Moreover, the presence of some endocrine and mucin-producing cell types in the so called "pyloric metaplasia" led the Authors to hypothesize that the latter may be a trivial event.