[Disorders of lipid metabolism in patients with cholelithiasis and gallbladder cholesterosis depending on apolipoprotein E genotype].

The work was aimed to study blood lipid spectrum in 133 patients with cholelithiasis (CL) and 159 with gallbladder cholesterosis (GC) as well as apoE genotypes (based on restriction fragment polymorphism) in 49 and 36 respectively. Lipid composition was shown to significantly differ in the two conditions. LDL cholesterol was increased in GC and TG in CL. A rise in LDL cholesterol in both groups was apparent before the age of 30 yr (34.6 +/- 8.4 and 52.6 +/- 12.9% respectively), that in TG and VLDL after 40 yr. E3/3 genotype (norm) was identified in 75.5 +/- 6.2% of the patients with CL and in 83.4 +/- 6.2% in those with GC (p < 0.05). e4 allele (mutation) equally frequently occurred in 10.2 +/- 4.3 and 8.1 +/- 4.5% of patients with CL and GC (p > 0.5), e2 allele in 14.5 +/- 5.0 and 8.1 +/- 4.5% (p < 0.05). These data suggest that patients of both groups equally frequently suffered disturbances in metabolism of saturated (e2 allele) and polyunsaturated (e4 allele) fatty acids predisposing for hypercholesterolemia and hyperlipidemia. They explain why CL is frequently associated with cholesterosis and GC with the formation of caliculi. However, the absence of significant correlation between CL, GC and alleles e2, e4 suggests participation of other factors in pathogenesis of these diseases (LP(a), LDL heterogeneity).

[Possibility of correction of the lipid disorders in patients with cholelithiasis and gallbladder cholesterosis].

OBJECTIVE: To evaluate the possibility of incorporating organic drugs Hepatosan and Entherosan in the complex therapy of patients with gallstone disease and gall bladder cholesterosis (reticulated polypus form) on the basis of literature data and own research. RESULTS: It has been found that the physiological effect of drugs Entherosan and Hepatosan is directed on the improvement cavity and wall digestion processes, that leads to the reduction (disappearance) of dyspeptic symptoms (eliminating discomfort in the epigastrium, bloating, diarrhea) in most of the patients. The main features of Entherosan are: normalization of gastro-intestinal tract motor activity, intestinal microflora, enteroprotective effect of the drug and its influence on intestinal and cellular pools of cholesterol that leads to the activation of cavitary and parietal digestion. The essential point of Hepatosan is to stimulate 7alpha-hydroxylase, resulting in strengthening of cholesterol oxidation and to an increase the pool of LCD in enterohepatic circulation. This factor, coupled with hepatoprotective action of the drug, ensures the deletion of biliary insufficiency. CONCLUSION: The incorporation of drugs Entherosan and Hepatosan in the complex conservative therapy of cholelithiasis and reticulated polypus forms of gall bladder cholesterosis is pathogenetically substantiated.

[Genetic aspects of bile production].

This article represented a modern view of and choleproduction and choleexcretion processes. It was presented secretion and transport of major bile components machineries as well as role of genes that are involved in protein-transporters biosynthesis.