Hepatocanalicular bile salt export pump deficiency in patients with progressive familial intrahepatic cholestasis.
Gastroenterology
; 117(6): 1370-9, 1999 Dec.
Article
in En
| MEDLINE
| ID: mdl-10579978
ABSTRACT
BACKGROUND & AIMS:
Progressive familial intrahepatic cholestasis (PFIC), an inherited liver disease of childhood, is characterized by cholestasis and either normal or increased serum gamma-glutamyltransferase activity. Patients with normal gamma-glutamyltransferase activity have mutations of the FIC1 locus on chromosome 18q21 or mutations of the BSEP gene on chromosome 2q24. Also, patients with bile acid synthesis defects have low gamma-glutamyltransferase activity. We investigated expression of the bile salt export pump (BSEP) in liver samples from patients with a PFIC phenotype and correlated this with BSEP gene mutations.METHODS:
BSEP and multidrug resistance protein 2 (MRP2) expressions were studied by immunohistochemistry in liver specimens of 28 patients and BSEP gene mutation analysis in 19 patients. Bile salt kinetics were studied in 1 patient.RESULTS:
Sixteen of 28 liver samples showed no canalicular BSEP staining. Staining for MRP2 showed a normal canalicular pattern in all but 1 of these samples. Ten of 19 patients showed BSEP gene mutations; BSEP protein expression was lacking in all 10 patients. No mutations were found in 9 of 19 patients, and in all except 1, BSEP protein expression was normal. Bile salt concentration in bile of BSEP-negative/MRP2-positive PFIC patients was 0.2 +/- 0.2 mmol/L (n = 9; <1% of normal) and in BSEP-positive PFIC patients 18.1 +/- 9.9 mmol/L (n = 3; 40% of normal). The kinetic study confirmed the dramatic decrease of bile salt secretion in BSEP-negative patients.CONCLUSIONS:
The findings show a close correlation between BSEP gene mutations and canalicular BSEP expression. Biliary secretion of bile salts is greatly reduced in BSEP-negative patients.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bile Acids and Salts
/
Cholestasis, Intrahepatic
/
ATP-Binding Cassette Transporters
Limits:
Female
/
Humans
/
Male
Language:
En
Journal:
Gastroenterology
Year:
1999
Document type:
Article
Affiliation country:
Netherlands