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Research Article| Volume 117, ISSUE 4, P435-442, April 1995

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Hypercalcemia decreases bile flow and increases biliary calcium in the prairie dog

  • Steven A. Ahrendt
    Affiliations
    Department of Surgery The Johns Hopkins Medical Institutions, Baltimore, Md. USA

    Department of Medicine, The Medical College of Virginia, Richmond, Va, USA
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  • Gretchen M. Ahrendt
    Affiliations
    Department of Surgery The Johns Hopkins Medical Institutions, Baltimore, Md. USA

    Department of Medicine, The Medical College of Virginia, Richmond, Va, USA
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  • Henry A. Pitt
    Affiliations
    Department of Surgery The Johns Hopkins Medical Institutions, Baltimore, Md. USA

    Department of Medicine, The Medical College of Virginia, Richmond, Va, USA
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  • Edward W. Moore
    Affiliations
    Department of Surgery The Johns Hopkins Medical Institutions, Baltimore, Md. USA

    Department of Medicine, The Medical College of Virginia, Richmond, Va, USA
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  • Keith D. Lillemoe
    Correspondence
    Reprint requests: Keith D. Lillemoe, MD, The Johns Hopkins Hospital, Department of Surgery, 600 N. Wolfe St., Blalock 603, Baltimore, MD 21287.
    Affiliations
    Department of Surgery The Johns Hopkins Medical Institutions, Baltimore, Md. USA

    Department of Medicine, The Medical College of Virginia, Richmond, Va, USA
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.
      Background. Biliary calcium is known to play an important role in the pathogenesis of gallstones. Calcium salts are present in all pigment gallstones and are also present in the core of most, if not all, cholesterol gallstones.
      Methods. The effects of acute hypercalcemia on bile flow and biliary calcium secretion were examined in 22 prairie dogs during intravenous taurocholate infusion (0, 1.0, 2.25, and 4.5 μmol/kg/min).
      Results. Bile flow was linearly correlated with bile acid output in both control (y=7.62x+13.5, r=0.98) and hypercalcemic (y=7.00x+10.4, r=0.96) animals At lower bile acid outputs (<3.0 μmol/kg/min), biliary, ionized calcium output per increment bile acid output was significantly increased in hypercalcemic animals (0.016 versus 0.011 μmol Ca++ μmol taurocholate, p<0.001). Bile ionized calcium concentrations approximated, Gibbs-Donnan predicted values only at low bile flow rate.
      Conclusions. Hypercalcemia decreases bile flow and increases biliary ionized calcium concentration in the prairie dog. These effects favor the precipitation of calcium salts in bile.
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      References

        • Moore EW
        The role of calcium in the pathogenesis of gallstones: Ca++ electrode studies of model bile salt solutions and other biologic systems.
        Hepatology. 1984; 4: 228S-243S
        • Been JM
        • Bills PM
        • Lewis D
        Microstructure of gallstones.
        Gastroenterology. 1979; 76: 548-555
        • Kaufman HS
        • Lillemoe KD
        • Magnuson TH
        • Frasca PF
        • Pitt HA
        Backscattered electron imaging and windowless energy dispersive x-ray microanalysis: a new technique for gallstone analysis.
        Scanning Microsc. 1990; 4: 853-862
        • Kibe A
        • Dudley MA
        • Halpern Z
        • Lynn MP
        • Breuer AC
        • Holzbach RT
        Factors affecting cholesterol monohydrate crystal nucleation time in model systems of supersaturated bile.
        J Lipid Res. 1985; 26: 1102-1111
        • Lillemoe KD
        • Magnuson TH
        • Peoples GE
        • Li L
        • Pitt HA
        Oral calcium supplementation increases biliary calcium.
        Gastroenterology. 1988; 94 ([Abstract]): A563
        • Magnuson TH
        • Lillemoe KD
        • Peoples GE
        • Pitt HA
        Oral calcium promotes pigment gallstone formation.
        J Surg Res. 1989; 46: 286-291
        • Graf J
        Canalicular bile salt-independent bile formation: concepts and clues from electrolyte transport in rat liver.
        Am J Physiol. 1983; 244: G233-G246
        • Moore EW
        • Rasmusen H
        • Shiffman M
        Pathogenesis of calcium-containing gallstones: all biliary calcium in the guinea pig is accounted for by passive entry from plasma.
        Gastroenterology. 1986; 90 ([Abstract]): 1748
        • Moore EW
        The regulation of ionized calcium [Ca++], in bile: taurocholate induces powerful Gibbs-Donnan effects in vitro.
        Gastroenterology. 1988; 94 ([Abstract]): A572
        • Cohen BI
        • Mosbach EH
        • McSherry CK
        • et al.
        Gallstone prevention in prairie dogs: comparison of chow vs. semisynthetic diets.
        Hepatology. 1986; 6: 874-880
        • Talalay P
        Enzymic analysis of steroid hormones.
        in: Methods of biochemical analysis. Interscience Publishers Inc, New York1960: 119-143
        • Rege RV
        • Dawes LG
        • Moore EW
        Biliary calcium secretion in the dog occurs primarity by passive convection and diffusion and is linked to bile flow.
        J Lab Clin Med. 1990; 115: 593-602
        • Magnuson TH
        • Ahrendt SA
        • Lillemoe KD
        • et al.
        Short-term fasting increases biliary calcium and bilirubin.
        J Surg Res. 1991; 50: 529
        • Layer P
        • Hotz J
        • Sinewe S
        • Goebell H
        Bile secretion in acute and chronic hypercalcemia in the cat.
        Dig Dis Sci. 1986; 31: 188-192
        • Limlomwongse L
        • Deachapunya C
        • Krishnamra N
        Biliary calcium and bile acid secretion in intact and TPTX rats with varying, plasma calcium concentration.
        Dig Dis Sci. 1988; 33: 685-691
        • Anwer MS
        • Clayton LM
        Role of extracellular Ca++ in hepatic bile formation and taurocholate transport.
        Am J Physiol. 1985; 249: G711-G718
        • Reichen J
        • Berr F
        • Le M
        • Warren GH
        Characterization of calcium deprivation-induced cholestasis in the perfused rat liver.
        Am J Physiol. 1985; 249: G48-G57
        • Baker AL
        • Wood RAB
        • Moosa AR
        • Boyer JL
        Sodium taurocholate modifies the bile acid-independent fraction of canalicular bile flow in the rhesus monkey.
        J Clin Invest. 1979; 64: 312-320
        • Blitzer BL
        • Boyer JL
        Cellular mechanisms of bile formation.
        Gastroenterology. 1982; 82: 346-357
        • Moore EW
        Bile, salt osmotic activity.
        Hepatology. 1986; 6 ([Abstract]): 1157
        • Moore EW
        • Sanyal AJ
        Ca++-binding to bile acids: I. Affinity and stoichiometry.
        Hepatology. 1989; 10: 731
        • Van der Meer R
        • Vonk RJ
        • Kuipers F
        Cholestasis and the interaction of sulfated glyco- and taurolithocholate with calcium.
        Am J Physiol. 1988; 254: G644-G649
        • Roda A
        • Hofmann AF
        • Mysels KJ
        The influence of bile salt structure on self-association in aqueous solutions.
        J Biol Chem. 1983; 258: 6362-6370
        • Knyrim K
        • Vakil N
        • Pfab R
        • Classen M
        The effects of intraduodenal bile acid administration on biliary secretion of ionized calcium and carbonate in man.
        Hepatology. 1989; 10: 134-142
        • Cummings SA
        • Hofmann AF
        Physiologic determinants of biliary calcium secretion in the dog.
        Gastroenterology. 1984; 87: 664-673
        • Jaeschke H
        • Benzick AE
        Paracellular and transcellular movement of calcium from blood into bile.
        Hepatology. 1989; 10 ([Abstract]): 729
        • Knyrim K
        • Vakil N
        The effects of biliary obstruction on ductal ionized calcium concentrations in man.
        Hepatology. 1988; 8 ([Abstract]): 1362
        • Moore EW
        • Celic L
        • Ostrow JD
        Interactions between ionized calcium and sodium taurocholate: bile salts are important buffers for prevention of calcium-containing gallstones.
        Gastroenterology. 1982; 83: 1079-1089
        • Rajagopalan N
        • Lindenbaum S
        The binding of Ca++ to taurine-and glycine-conjugated bile salt micelles.
        Biochim, Biophys Acta. 1982; 711: 66-74
        • Williamson BWA
        • Percy-Robb IW
        Contribution of biliary lipids to calcium binding in bile.
        Gastroenterology. 1980; 78: 696-702
        • Shimizu S
        • Rege RV
        • Webster CC
        • Ostrow JD
        • Celic L
        • Moore EW
        High-affinity binding of ionized calcium (Ca++) by conjugated bilirubin.
        Hepatology. 1987; 7 ([Abstract]): 1110
        • Dawes LG
        • Rege RV
        • Moore EW
        Bile salts, bilirubin, and carbonate: the major biliary binders of calcium.
        Hepatology. 1988; 8 ([Abstract]): 1258