Abstract

Cholesterol crystal formation in the gallbladder is a key step in gallstone pathogenesis. Gallbladder epithelial cells might prevent luminal gallstone formation through a poorly understood cholesterol absorption process. Genetic studies in mice have highlighted potential gallstone susceptibility alleles, Lith genes, which include the gene for megalin. Megalin, in conjunction with the large peripheral membrane protein cubilin, mediates the endocytosis of numerous ligands, including HDL/apolipoprotein A-I (apoA-I). Although the bile contains apoA-I and several cholesterol-binding megalin ligands, the expression of megalin and cubilin in the gallbladder has not been investigated. Here, we show that both proteins are expressed by human and mouse gallbladder epithelia. In vitro studies using a megalin-expressing cell line showed that lithocholic acid strongly inhibits and cholic and chenodeoxycholic acids increase megalin expression. The effects of bile acids (BAs) were also demonstrated in vivo, analyzing gallbladder levels of megalin and cubilin from mice fed with different BAs. The BA effects could be mediated by the farnesoid X receptor, expressed in the gallbladder. Megalin protein was also strongly increased after feeding a lithogenic diet. These results indicate a physiological role for megalin and cubilin in the gallbladder and provide support for a role for megalin in gallstone pathogenesis.

Highlights

  • Cholesterol crystal formation in the gallbladder is a key step in gallstone pathogenesis

  • We show that megalin expression by gallbladder epithelial cells (GBECs) is regulated by bile acids (BAs) but not by cholesterol, suggesting the participation of the transcription factor farnesoid X receptor (FXR)

  • We found that both megalin and cubilin mRNAs were expressed by GBECs isolated from human gallbladder (Fig. 1B)

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Summary

Introduction

Cholesterol crystal formation in the gallbladder is a key step in gallstone pathogenesis. The bile contains apoA-I and several cholesterol-binding megalin ligands, the expression of megalin and cubilin in the gallbladder has not been investigated. Megalin and cubilin are large, multiple-ligand receptors expressed on the apical surface of several epithelial tissues, such as the renal proximal tubule [18,19,20], the small intestine [21], the visceral yolk sac [19, 22, 23], and the male reproductive system [24] Both proteins are structurally different and bind several ligands in common as well as specific ligands [20]. The cooperative relationship between megalin and cubilin is reflected in the fact that in many absorptive epithelial cells both receptors are coexpressed [20, 25]

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