Bile Acids In Gastric Juice Research Articles

Assessing the progression of gastric cancer via profiling of histamine, histidine, and bile acids in gastric juice using LC-MS/MS

Bile acid (BA) imbalance may be directly associated with gastric cancer and indirectly influence stomach carcinogenesis via overexpression of histidine decarboxylase (HDC), which converts histidine (His) into histamine (HIST). Moreover, the progression of gastric cancer, could change the gut microbiome, including bacteria spp. that produce secondary BAs. Gastric juice has various metabolites that could indicate gastric cancer-related stomach conditions. Therefore, profiling of HIST, His, and BAs in gastric juice is crucial for understanding the etiological mechanisms of gastric cancer. We used a profiling method to simultaneously determine targeted metabolites in gastric juice using liquid chromatography-tandem mass spectrometry (LC-MS/MS). We successfully analyzed 70 human gastric juice samples from patients with chronic superficial gastritis (CSG, n = 20), intestinal metaplasia (IM, n = 12), and gastric cancer (n = 38). Furthermore, we investigated the relevance between BA metabolism and gastric cancer. There were statistical differences in the metabolism of cholic acid (CA) into deoxycholic acid (DCA) based on the progression of CSG into IM and gastric cancer. Hence, the progression of gastric cancer might be related to the alterations in gut microbiome composition. We provide insight into the etiological mechanisms of the progression of gastric cancer and biomarkers to diagnose and treat gastric cancer.

Duodenogastral reflux and its influence on manifestation of morphological changes of gastric mucosa.

Among the diseases of the gastroduodenal zone chronic gastritis (CG) occupies one of the leading positions. One of the main forms of CG is reflux gastritis (RG) based on long-term location of duodenal content in the gastric antrum , so-called duodenal reflux (DR). It is w ell known that stable inflammatory response of the gastric mucosa (GM) appears under the influence of bile acid and gastric juice , leading to chronic antral gastritis followed by gradual development of atrophy, metaplasia and dysplasia appearance. Therefore the aim of our work was to investigate the influence of the DR on the course of chronic hepatitis and morphological changes in the gastric mucosa. We observed 70 patients with chronic RG, aged from 22 to 59 years, average age – 43,5±1,2 years. The control group consisted of 25 healthy individuals of both sexes aged from 19 to 39 years. As a result it was found out that pain and dyspeptic syndromes caused problems most of all. While studying the content of bile acids in gastric juice of all patients examined it was higher (1,42±0,05 g/L) in comparison with the control group (0,65±0,04 g/L). C ontent of bile acids in groups of RG patients with atrophy and without it was analyzed. T he role of DR as an independent factor of recomposing changes in GM in chronic RG was proved.

Continuous 99mTc-HIDA infusion as a method for measuring duodenogastric reflux

The continuous 99mTc-HIDA infusion test is presented as a method for measuring duodenogastric reflux as well as for studying biliary elimination of the compound when it is administered by constant intravenous infusion. Thirty patients were studied: (a) ten patients with a T tube placed in the biliary tree were used to study the elimination of 99mTc-HIDA in the bile; (b) ten normal subjects were used as a control group; and (c) ten patients were studied who had undergone Billroth I gastrectomy for peptic ulceration. Studies of subjects in groups (b) and (c) were used to assess duodenogastric reflux by this test, correlating it with the measurement of bile acids in gastric juice. When 99mTc-HIDA was administered by constant intravenous infusion it resulted in an increased elimination in bile for the first 80-100 min, and the concentration in bile then remained relatively constant for the rest of the test. With respect to the duodenogastric reflux study group, reflux rates in the patients who had been operated on were higher than those in the control group, with statistically significant differences. Minimum reflux rates were found in the normal subjects. Assessment of reflux by 99mTc-HIDA correlated closely with the results of bile acid concentrations in Billroth I patients (r = 0.75, P less than 0.001) and control subjects (r = 0.85, P less than 0.001). Our results demonstrate that continuous 99mTc-HIDA perfusion is a useful, accurate and objective method for measuring duodenogastric reflux.

Levels of nitrite, nitrate, N-nitroso compounds, ascorbic acid and total bile acids in gastric juice of patients with and without precancerous conditions of the stomach

To determine the relevance of gastric juice factors to gastric carcinogenesis, 56 patients with unoperated stomachs undergoing endoscopy for dyspepsia had gastric juice aspirated and analysed for pH, ascorbic acid, total bile acids, nitrite, nitrate and total nitroso compounds (NOCs). Plasma was obtained for vitamin C estimation. Antral and body biopsies were assessed for gastritis, Helicobacter pylori, atrophy and intestinal metaplasia (IM). Patients with chronic atrophic gastritis (n = 17) had lower gastric juice ascorbic acid concentrations (P less than 0.001), higher pH (P less than 0.05) and higher incidence of H. pylori infection (P less than 0.001) than normal subjects (n = 12). Patients with reflux gastritis (n = 9) had higher total bile acids (P less than 0.01). Patients with chronic gastritis and IM (n = 11) had higher gastric juice pH (P less than 0.01) and total bile acid concentrations (P less than 0.05), and lower gastric ascorbic acid concentrations (P less than 0.01) than those with chronic gastritis and no IM (n = 24). In chronic gastritis, high nitrite concentrations were associated with high pH (P less than 0.01). However, there were no significant differences in plasma vitamin C or gastric nitrite, nitrate or total NOC concentrations in relation to gastric histology. We conclude that the premalignant condition IM is associated with H. pylori infection, low gastric ascorbic acid levels and elevated total bile acids, but not to elevation in nitrite or total NOCs in fasting gastric juice.

New technique for analysing conjugated bile acids in gastric juice.

A new technique of high performance liquid chromatography (HPLC) was developed for the analysis of conjugated bile acids in gastric juice. The assay is rapid, sensitive, and highly specific for bile acid conjugates over the range 30-10,000 mumol/l and is not affected by the presence of food. Ten patients with a variety of common upper gastrointestinal disorders underwent continuous gastric aspiration for 16 hours, including a fasting, post-prandial, and nocturnal period, and aliquots of aspirates were analysed every two hours by the HPLC technique for the six most prevalent bile acid conjugates present in human hepatic bile. Intragastric bile acid concentrations were lowest in the post-prandial period and highest in the early hours of the morning. Conjugated bile acid proportions, or profiles, varied considerably from patient to patient, but tended to remain uniform over time in individual patients. It is concluded that HPLC is superior to enzymatic techniques for the analysis of conjugated bile acids in the upper gastrointestinal tract.

Quantification of Duodenogastric Reflux in the Operated Stomach Using <sup>99m</sup>Tc-HIDA Administered by Continuous Intravenous Infusion as a Duodenal Marker

We quantified duodenogastric reflux using continuous intravenous 99mTc-HIDA infusion, subsequently determining it in gastric juice and correlating it with the reading for total bile acids in gastric juice. The determinations were made on 10 healthy volunteers who served as a control group, and on 30 patients who had undergone gastric surgery [ 10 Billroth I (B-I), 10 Bilroth II (B-II) and 10 bilateral truncular vagotomy plus pyloroplasty (BTV + P)]. Our results show that the gastric surgery patients presented significantly higher reflux quantities (p < 0.001) than the control group. When the gastric surgery patients were compared with each other, the resection patients (B-I, B-II) showed significantly higher reflux rates (p < 0.001) than the BTV + P group, with no differences being found among the gastrectomy patients according to reconstruction technique (B-I, B-II). We also found a highly significant correlation (p < 0.001) between 99mTc-HIDA and bile acid concentration in gastric juice.

HPLC assay of conjugated bile acids in gastric juice during ursodeoxycholic acid (Deursil®) therapy of bile reflux gastritis

A rapid high-performance liquid chromatographic method for the direct assay of the taurine and glycine conjugated bile acids in human gastric juice is described. After extraction with Sep-Pak C 18 cartridges, compounds are baseline resolved on a reversed-phase column and detected by UV absorption. The procedure is linear from 10 μmol l −1 to 1200 μmol l −1, with recovery rates ranging from 87 to 100%. The present method is applicable to the quantification of bile acid conjugates in human gastric bile with satisfactory sensitivity, selectivity and precision. Intragastric bile acid compositions in 10 patients with bile reflux gastritis during Deursil® or placebo treatment are presented.

Dietary fibre and peptic ulcer.

Until some years ago dietary regulations constituted the most important part of peptic ulcer treatment. The clinical value of the traditional, bland, low-fibre diet has never been documented. A survey is given of the influence of a high-fibre diet on peptic ulcer disease. Studies evaluating the effect of a high-fibre diet in the treatment of gastric and duodenal ulcer as well as the prophylactic effect on duodenal ulcer recurrence are reviewed. Experimental studies in vitro and in vivo have been performed to look at the possible mechanisms by which fibre could innfluence ulcer diathesis. The fibre components, guar gum (Guarem) and fibre-enriched wheat bran (Fiberform) effectively bind bile acids in gastric juice both in vitro and in vivo. The bile acid binding in vivo is effective not only in healthy subjects but also in patients with gastric ulcer. Fibre-enriched wheat bran prolongs the meal-induced pH elevation and reduces postprandial pepsin concentrations. The fibre-induced alterations of in-tragastric pH and pepsin are not due to alterations of gastric emptying as physiological doses of the fibre components mentioned do not influence the gastric emptying of a semi-solid meal in healthy subjects.The clinical studies revealed a prophylactic effect of a high-fibre diet in the prevention of duodenal ulcer relapse. However, in the treatment of acute gastric and duodenal ulcer, there seems to be no obvious advantage in the use of a high-fibre diet compared with the traditional bland diets.

Duodenogastric Reflux: Correlations among Bile Acid Pattern, Mucus Secretion, and Mucosal Damage

Forty-five patients with bile reflux at endoscopic examination, confirmed by titration of bile acids in gastric juice, were admitted to the study and divided into three groups in accordance with histologic results: normal findings, chronic superficial gastritis, and chronic atrophic gastritis. Bile acid pattern was determined in duodenal samples by high-performance liquid chromatography titration, and the mucoprotein content of gastric juice was assessed. The results of qualitative analysis of bile acid showed an increase of deoxycholic acid in patients with atrophic gastritis (p less than 0.05) in comparison with controls; determination of taurine and glycine conjugates showed an increase of taurodeoxycholic acid in patients with atrophic gastritis (p less than 0.01) compared with controls. The composition of mucus was altered only in patients with atrophic gastritis. Whether the increase in deoxycholic acid in biliary reflux is a factor in the development of chronic atrophic gastritis or is secondary to the increase of gastric pH, detectable in this condition, is still uncertain. However, the increase of deoxycholic acid and its taurine conjugates may be a factor that leads to persistence of mucosal lesions.

Aspects of the determination of free bile acids in gastric juice

Aspects of the determination of free bile acids in gastric juice

Determination of bile acids and lysolecithin in artificial and natural gastric juice by HPLC for characterization of antacida

AbstractWork‐up procedures and HPLC separation systems for determination of taurocholic, glycocholic, chenodeoxycholic, and cholic acids and lysolecithin in artificial and natural gastric juice are described. These compounds are used for testing the binding capacity of antacida to the individual analytes. Work‐up is simple, no extraction or filtration being required. The optimized combinations of stationary and mobile phases allow selective and sensitive determination of the respective bile acids in gastric juice. For optimization, the capacity factors of two related bile acids were evaluated for numerous commercial stationary phases. The mechanism of retention is different for free and conjugated bile acids. Special aspects of routine analysis are discussed.

Measurement of total bile acids in gastric juice.

An established method for the assay of total bile acids was validated for use in fasting and post-prandial gastric juice samples. Fasting and post-prandial intragastric bile acid concentrations were measured in 29 healthy volunteers, 15 patients after vagotomy and gastrojejunostomy (V and GJ) and 15 patients after vagotomy and pyloroplasty (V and P). Healthy female volunteers had higher post-prandial bile acid concentrations than age matched healthy males (p less than 0.02). Patients with V and GJ had higher fasting and post-prandial bile acid concentrations than age and sex matched control subjects (p less than 0.01). Patients with V and P had higher bile acid concentrations than control subjects only in post-prandial samples (p less than 0.05).