|Budget Amount *help
¥3,200,000 (Direct Cost : ¥3,200,000)
Fiscal Year 1999 : ¥600,000 (Direct Cost : ¥600,000)
Fiscal Year 1998 : ¥500,000 (Direct Cost : ¥500,000)
Fiscal Year 1997 : ¥2,100,000 (Direct Cost : ¥2,100,000)
Multiple cholesterol stones are associated with more biliary complications and exhibit more rapid cholesterol nucleation than solitary stones. Secretory or group II phospholipase AィイD22ィエD2 (PLAィイD22ィエD2-II) levels in gallbladder bile were significantly higher in patients with multiple cholesterol stones than in those with solitary stones or control subjects. Increased biliary PLAィイD22ィエD2-II levels in multiple cholesterol stones were associated with a concomitant increase in the protein and hexosamine concentrations as well as gallbladder bile viscosity. Increased PLAィイD22ィエD2-II in gallbladder bile may be of pathogenetic importance in patients with multiple cholesterol stones, probably through potentiating gallbladder mucosal inflammation with associated biliary alterations favoring cholesterol crystal formation.
Ursodeoxycholate (UDC) decreases biliary levels of various pronucleating proteins, possibly due to its membrane-protective effects on the inflamed gallbladder mucosa. Long-te
rm UDC administration was observed to lower the increased PLAィイD22ィエD2-II protein mass and mRNA level as well as the PLAィイD22ィエD2-V mRNA level in the gallbladders of patients with multiple cholesterol stones, which in turn may be of therapeutic importance in improving the gallbladder mucosal inflammation. Effects of UDC on secretory low molecular weight PLAィイD22ィエD2s as inflammatory mediators may relate to the reported efficacy of UDC treatment in cholesterol gallstone disease.
Intrahepatic calculi is characterized by an intractable course and frequent recurrences. Chronic proliferative cholangitis may underlie the complex nature of the disease. PLAィイD22ィエD2-II levels were significantly higher in the bile from the stone-containing hepatic ducts than in the ductal bile from gallbladder stone patients. The increased sPLAィイD22ィエD2 levels were associated with a concomitant increase in prostaglandin EィイD22ィエD2 and total mucin concentrations. The affected bile ducts showed an increased mRNA level of PLAィイD22ィエD2-II compared with the ducts from control subjects. In intrahepatic calculi, an enhanced expression of the PLAィイD22ィエD2-II may be of pathophysiological significance for the chronic proliferative cholangitis, probably through biliary alterations favoring growth of preexisting stones and even further progressions.