Intact Enterohepatic Circulation Research Articles

Increased hepatic blood flow during enteral immune-enhancing diet gavage requires intact enterohepatic bile cycling

ObjectivesTotal hepatic blood flow (HBF) via the hepatic artery and portal vein is highly dependent on gastrointestinal perfusion. During postprandial hyperemia, intestinal blood flow depends on nutrient composition, gastrointestinal location, and time. Immune-enhancing diets (IEDs) containing n-3 polyunsaturated fatty acids (PUFAs) selectively augment blood flow in the ileum at 60–120 min via a bile-dependent mechanism. My colleagues and I hypothesized that liver blood flow would be similarly affected by IEDs containing n-3 PUFAs. MethodsMean arterial blood pressure, heart rate, and effective HBF (galactose clearance) were measured in anesthetized male Sprague-Dawley rats after gastric gavage of either a control diet (CD, Boost, Novartis) or an IED (Impact, Nestle Nutrition), with or without bile-duct ligation (BDL), and with or without supplemental bile (bovine, dried, unfractionated). Significance was assessed by 2-way ANOVA for repeated measures with the Tukey-Kramer honestly significant difference test. ResultsCompared with baseline levels, a CD increased HBF (peak at 40 min , *P < 0.05) whereas an IED increased HBF in two distinct peaks at 40 min (*P < 0.05) and 120 min (*P < 0.05), but BDL prevented both the early (CD and IED, †P < 0.05) and late peaks (IED, †P < 0.05). Bile supplementation in the CD + BDL or IED + BDL groups restored neither the CD peak nor the early or late IED peaks. ConclusionsHBF during absorptive intestinal hyperemia is modulated by a mechanism that requires an intact enterohepatic circulation. The early peaks at 40 min (CD or IED) were prevented by BDL, even though fat absorption in the proximal gut occurs by bile-independent direct absorption. Bile supplementation with the diet (CD + BDL or IED + BDL) was insufficient to restore HBF hyperemia, which implies that a relationship exists between intestinal and hepatic blood flow that is not solely dependent on bile-mediated intestinal fat absorption and bile recirculation.

Mice with chimeric livers are an improved model for human lipoprotein metabolism.

ObjectiveRodents are poor model for human hyperlipidemias because total cholesterol and low density lipoprotein levels are very low on a normal diet. Lipoprotein metabolism is primarily regulated by hepatocytes and we therefore assessed whether chimeric mice extensively repopulated with human cells can model human lipid and bile acid metabolism.DesignFRG [ F ah(−/−) R ag2(−/−)Il2r g (−/−)]) mice were repopulated with primary human hepatocytes. Serum lipoprotein lipid composition and distribution (VLDL, LDL, and HDL) was analyzed by size exclusion chromatography. Bile was analyzed by LC-MS or by GC-MS. RNA expression levels were measured by quantitative RT-PCR.ResultsChimeric mice displayed increased LDL and VLDL fractions and a lower HDL fraction compared to wild type, thus significantly shifting the ratio of LDL/HDL towards a human profile. Bile acid analysis revealed a human-like pattern with high amounts of cholic acid and deoxycholic acid (DCA). Control mice had only taurine-conjugated bile acids as expcted, but highly repopulated mice had glycine-conjugated cholic acid as found in human bile. RNA levels of human genes involved in bile acid synthesis including CYP7A1, and CYP27A1 were significantly upregulated as compared to human control liver. However, administration of recombinant hFGF19 restored human CYP7A1 levels to normal.ConclusionHumanized-liver mice showed a typical human lipoprotein profile with LDL as the predominant lipoprotein fraction even on a normal diet. The bile acid profile confirmed presence of an intact enterohepatic circulation. Although bile acid synthesis was deregulated in this model, this could be fully normalized by FGF19 administration. Taken together these data indicate that chimeric FRG-mice are a useful new model for human lipoprotein and bile-acid metabolism.

The effect of pancreatic and biliary depletion on the in vivo pharmacokinetics of digoxin in pigs

Several transporter systems in the liver and intestine are known to change their expression and function during cholestatic disease states. The objective of the present in vivo study was to investigate the effect of biliary depletion, as a method to mimic cholestasis, on the bioavailability and disposition of digoxin in biliary and pancreatic duct cannulated pigs. The study was divided in two parts. In the first part, a solution of 10μg/kg digoxin was administered intravenously to the cannulated pigs with intact enterohepatic circulation (Control) and during depletion of the bile and pancreatic juice. In the second part, the same dose of digoxin was adminstered intraduodenally with intact enterohepatic circulation (Control) and during depletion of either bile or pancreatic juice or both. Biliary depletion decreased the flow of bile and pancreas juice as well as the amount of digoxin appearing in the bile. Deprivation of both bile and pancreas juice significantly increased the bioavailability of digoxin, the plasma AUC after enteral administration increased from 17.6±4.2nmol/lh (Control) to 29.6±8.3nmol/lh (P<0.05). The biliary clearance decreased significantly, from 0.22±0.11l/h/kg (Control) to 0.04±0.03l/h/kg during pancreatic and biliary depletion (P<0.05). There was a significant decrease in elimination half-life (P<0.05) and volume of distribution (P<0.01) during the depletion experiments while the systemic clearance remained unchanged. The results clearly suggest that biliary depletion trigger a short-term downregulation, most likely posttranscriptionally mediated, of a sinusoidal uptake transporter in the liver, possibly a pig ortholog of OATP.

Overexpression of cholesterol transporter StAR increases In Vivo rates of bile acid synthesis in the rat and mouse

Bile acid synthesis (BAS) occurs mainly via two pathways: the “neutral” pathway, which is initiated by highly regulated microsomal CYP7A1, and an “acidic” pathway, which is initiated by mitochondrial CYP27A1. Previously, we have shown that overexpression of the steroidognic acute regulatory protein (StAR), a mitochondrial cholesterol transport protein, increases bile acid biosynthesis more than 5-fold via the acidic pathway in primary rat hepatocytes. This observation suggests that mitochondrial cholesterol transport is the ratelimiting step of BAS via this pathway. The objective of this study was to determine the effect of increased StAR on rates of BAS in vivo. Overexpression of StAR and CYP7A1 were mediated via infection with recombinant adenoviruses. BAS rates were determined in chronic biliary-diverted rats and mice, and in mice with an intact enterohepatic circulation. The protein/messenger RNA levels of StAR and CYP7A1 increased dramatically following overexpression. Overexpression of StAR or CYP7A1 led to a similar 2-fold (P &lt; .01) increase in BAS over up-regulated (approximately 2-fold) 3-day chronic biliary-diverted control rats. Additionally, overexpression of StAR led to more than 3- and 6-fold increases over controls in the rates of BAS in biliary-diverted and intact mice, respectively (P &lt; .01). In conclusion, in both rats and mice in vivo, overexpression of StAR led to a marked increase in the rates of BAS initiated by delivery of cholesterol to mitochondria containing CYP27A1. (Hepatology 2004;40:910-917).

Cholemic transgenic mice: A novel animal model to investigate the effects of bile acids

Introduction: Laboratory investigations into cholestatic liver disease and the effects of cholemia on organ function are long-standing subjects of scientific enquiry. A widely-used strategy to investigate these topics relies on animal-based research using experimental animal models. Targeted inactivation of the spgp gene, the gene responsible for expressing the bile salt export pump (BSEP) in the hepatocyte canalicular membrane impairs the canalicular secretion of bile salts resulting in systemic cholemia. The results of in vitro experiments have established bile acids as pro-oxidants and the collection of unambiguous in vivo data on the pro-oxidant activity of bile acids in the existing models of cholemia cannot be done. Therefore, we decided to use these genetically modified mice to determine whether this model of cholemia has evidence of extrahepatic or systemic oxidative stress, one of the features of cholestatic liver disease. Methods: The extent of lipid peroxidation in livers, kidneys, hearts and brains harvested from cholemic homozygous ( spgp −/−) mice using the thiobarbituric acid reactive substances (TBARS) assay. The data were compared to equivalent data collected from heterozygous ( spgp +/−) and control mice. Results: We found (1) substantial increases in malondialdehyde (MDA) levels in the brains and hearts; (2) a moderate increase in MDA levels in the kidneys; and (3) no change in MDA levels in the livers of the homozygous cholemic mice compared to the control and heterozygous mice. Discussion: The transgenic mouse model of cholemia has an intact enterohepatic circulation and is uncomplicated by the adverse consequences of hepatotoxins or biliary surgery. Hepatocellular injury, as well as plasma and tissue accumulation of bilirubin and other liver-derived compounds are also negligible. Although this preliminary study could not establish a causal relationship between cholemia and oxidative stress, we believe this model is worthy of further investigation to study the impact of short-term and long-term cholemia on diverse physiological and biochemical functions such as trying to establish a causal role for bile acids in the development of oxidative stress in cholestatic liver disease.

Overexpression of cholesterol transporter StAR increases in vivo rates of bile acid synthesis in the rat and mouse.

Bile acid synthesis (BAS) occurs mainly via two pathways: the "neutral" pathway, which is initiated by highly regulated microsomal CYP7A1, and an "acidic" pathway, which is initiated by mitochondrial CYP27A1. Previously, we have shown that overexpression of the steroidogenic acute regulatory protein (StAR), a mitochondrial cholesterol transport protein, increases bile acid biosynthesis more than 5-fold via the acidic pathway in primary rat hepatocytes. This observation suggests that mitochondrial cholesterol transport is the rate-limiting step of BAS via this pathway. The objective of this study was to determine the effect of increased StAR on rates of BAS in vivo. Overexpression of StAR and CYP7A1 were mediated via infection with recombinant adenoviruses. BAS rates were determined in chronic biliary-diverted rats and mice, and in mice with an intact enterohepatic circulation. The protein/messenger RNA levels of StAR and CYP7A1 increased dramatically following overexpression. Overexpression of StAR or CYP7A1 led to a similar 2-fold (P <.01) increase in BAS over up-regulated (approximately 2-fold) 3-day chronic biliary-diverted control rats. Additionally, overexpression of StAR led to more than 3- and 6-fold increases over controls in the rates of BAS in biliary-diverted and intact mice, respectively (P <.01). In conclusion, in both rats and mice in vivo, overexpression of StAR led to a marked increase in the rates of BAS initiated by delivery of cholesterol to mitochondria containing CYP27A1.

Regulation of oxysterol 7α-hydroxylase (CYP7B1) in the rat

Cholesterol metabolized to 7α-hydroxylated bile acids is a principle pathway of cholesterol degradation. Cholesterol 7α-hydroxylase (CYP7A1) is the initial and rate-determining enzyme in the “classic pathway” of bile acid synthesis. An “alternative” pathway of bile acid synthesis begins with 27-hydroxylation of cholesterol by 27-hydroxylase (CYP27), followed by 7α-hydroxylation by oxysterol 7α-hydroxylase (CYP7B1). The aim of the current study was to investigate the regulation of CYP7B1 by bile acids, cholesterol, and thyroid hormone in a previously well-studied in vivo model of bile acid synthesis, and to compare its regulation to that of CYP7A1. Three study groups were examined. In the first, male Sprague-Dawley rats with intact enterohepatic circulations were fed normal chow (controls), cholestyramine (CT), cholic acid (CA), chenodeoxycholic acid (CDCA), deoxycholic acid (DCA), or cholesterol (Chol). In the second group, taurocholate (TCA) was continuously intraduodenally infused for 48 hours to chronic biliary diverted rats. In a third set of studies, squalestatin, an inhibitor of cholesterol synthesis, was intravenously infused for 48 hours. In a fourth set of studies, the diurnal variation in CYP7B1 was compared to that of CYP7A1. At the end of each study livers were harvested, and CYP7B1 and CYP7A1 activities and mRNA levels were determined. Complete biliary diversion significantly increased the specific activity (SA) of both CYP7B1 (↑ 212%; P <.002) and CYP7A1 (↑ 212%; P <.007). Intraduodenal infusion of TCA to rats with biliary diversion decreased SA of both CYP7B1 (↓ 29%; P <.001) and CYP7A1 (↓ 46%; P <.01). The addition of CA, CDCA, or DCA to rat chow led to downregulation of CYP7B1 SAs by 42% (P <.003), 51% (P <.009), and 47% (P <.003), and CYP7A1 SAs by 32% ± 6% (P <.003), 73% ± 9% (P <.002), and 60% ± 13% (P <.004), respectively. CT feeding upregulated both CYP7B1 (↑ 136%; P <.004) and CYP7A1 (↑ 216%; P <.001) SAs. While Chol feeding significantly upregulated CYP7A1 SA, no significant increase in CYP7B1 SA was found. Conversely, as previously shown in vitro, inhibition of cholesterol synthesis significantly suppressed both CYP7A1 and CYP7B1 activity and mRNA levels. Both CYP7B1 and CYP7A1 underwent diurnal variation, with peak and trough values for CYP7B1 lagging approximately 6 hours behind CYP7A1. We conclude that, in the rat, like CYP7A1, CYP7B1 demonstrates diurnal rhythm and is regulated by bile acids and cholesterol. © 2003 Elsevier Inc. All rights reserved.

Measurement of parameters of cholic acid kinetics in plasma using a microscale stable isotope dilution technique: application to rodents and humans

A stable isotope dilution method is described that allows measurement of cholic acid (CA) kinetics, that is, pool size, fractional turnover rate (FTR), and synthesis rate in mice, rats, and humans. Decay of administered [2,2,4,4-2H4]CA enrichment was measured in time in 50-μl plasma samples by gas-liquid chromatography/electron capture negative chemical ionization-mass spectrometry, applying the pentafluorobenzyl-trimethylsilyl derivative. The kinetic data expressed species-dependent differences. The CA pool sizes were 16.8 ± 2.1, 10.6 ± 1.2, and 2.4 ± 0.7 μmol/100 g body weight for mice, rats, and humans, respectively. The FTR values were 0.44 ± 0.03, 0.88 ± 0.10, and 0.46 ± 0.14 per day for mice, rats, and humans. The corresponding synthesis rates were 7.3 ± 1.6, 9.3 ± 0.1, and 1.0 ± 0.2 μmol/100 g body weight per day. The human data agreed well with literature data obtained by conventional isotope dilution techniques. For rats and mice these are the first reported isotope dilution data. The method was validated by confirmation of isotopic equilibrium between biliary CA and plasma CA in the rat. Its applicability was demonstrated by the observation of increased CA FTR and CA synthesis rate in rats fed cholestyramine, which is known to increase fecal bile acid excretion. The presented stable isotope dilution method enables the determination of CA kinetic parameters in small plasma samples. The method can be applied in unanesthetized rodents with an intact enterohepatic circulation and may also be valuable when studying the development of human neonatal bile acid kinetics.—Hulzebos, C. V., L. Renfurm, R. H. Bandsma, H. J. Verkade, T. Boer, R. Boverhof, H. Tanaka, I. Mierau, P. J. J. Sauer, F. Kuipers, and F. Stellaard. Measurement of parameters of cholic acid kinetics in plasma using a microscale stable isotope dilution technique: application to rodents and humans.

Effect of Chronic Administration of Tauro-hyodeoxycholic Acid on Biliary Bile Acid Composition and on Biliary Lipid Secretion in Humans

Tauro-hyodeoxycholic acid is a hydrophilic bile acid of potential interest for treating cholestatic liver diseases. Bile acid pool is enriched with this bile acid during acute administration in patients with interrupted enterohepatic circulation. The aim of our study was to check the effect of chronic administration of tauro-hyodeoxycholic acid on biliary lipid composition and secretion in man with intact enterohepatic circulation. We studied 7 dyspeptic patients before and during taurohyodeoxycholic acid 750 mg/day given for 6-8 weeks. We measured bile acid composition in duodenal aspirate, and biliary lipid secretion was also measured in 5 of these patients using a duodenal perfusion technique. Tauro-hyodeoxycholic was undetectable in duodenal aspirate in all patients before treatment, and was 2%, 4%, 5%, 7%, 7%, 8% and 13% of biliary bile acid during treatment in individual patients. The proportion of cholic, deoxycholic, chenodeoxycholic ursodeoxycholic and lithocholic acid was similar before and during treatment. Bile acid duodenal output remained unchanged during taurohyodeoxycholic by comparison with pretreatment with median difference -0.3 mmol (95% confidence interval 1.6 mmol). The corresponding difference for duodenal cholesterol and phospholipid output was 0.1 mmol (0.2 mmol) and 0.2 mmol (0.6 mmol). By contrast with acute administration in patients with interrupted enterohepatic circulation, chronic administration of tauro-hyodeoxycholic to man with intact enterohepatic circulation has little effect on biliary lipid composition and secretion.

Effect of Chronic Administration of Tauro-hyodeoxycholic Acid on Biliary Bile Acid Composition and on Biliary Lipid Secretion in Humans

Background: Tauro-hyodeoxycholic acid is a hydrophilic bile acid of potential interest for treating cholestatic liver diseases. Bile acid pool is enriched with this bile acid during acute administration in patients with interrupted enterohepatic circulation. The aim of our study was to check the effect of chronic administration of tauro-hyodeoxycholic acid on biliary lipid composition and secretion in man with intact enterohepatic circulation. Methods: We studied 7 dyspeptic patients before and during taurohyodeoxycholic acid 750 mg/day given for 6-8 weeks. We measured bile acid composition in duodenal aspirate, and biliary lipid secretion was also measured in 5 of these patients using a duodenal perfusion technique. Result: Tauro-hyodeoxycholic was undetectable in duodenal aspirate in all patients before treatment, and was 2%, 4%, 5%, 7%, 7%, 8% and 13% of biliary bile acid during treatment in individual patients. The proportion of cholic, deoxycholic, chenodeoxycholic ursodeoxycholic and lithocholic acid was similar before and during treatment. Bile acid duodenal output remained unchanged during taurohyodeoxycholic by comparison with pretreatment with median difference-0.3 mmol (95% confidence interval 1.6 mmol). The corresponding difference for duodenal cholesterol and phospholipid output was 0.1 mmol (0.2 mmol) and 0.2 mmol (0.6 mmol). Conclusions: By contrast with acute administration in patients with interrupted enterohepatic circulation, chronic administration of tauro-hyodeoxycholic to man with intact enterohepatic circulation has little effect on biliary lipid composition and secretion.

Drug enterocyte adducts: Possible causal factor for diclofenac enteropathy in rats

Background & Aims: Enteropathy is a frequent complication of diclofenac and other nonsteroidal anti-inflammatory drugs, yet little is known about the underlying mechanism. One possibility is that reactive metabolites of diclofenac form adducts with enterocyte macromolecules, as previously shown for liver. We addressed this possibility by using immunohistochemistry to detect diclofenac adducts. Methods: Rats were treated orally with diclofenac (10–100 mg/kg) and killed after 1–24 hours, and their gastrointestinal (GI) tracts were evaluated for ulcer number and area. Adduct distribution and intensity were assessed by immunohistochemistry by using a technique to simultaneously process and stain multiple intestinal rings. Results: Drug treatment led to dose-dependent formation of both adducts and ulcers only in small intestine and only in animals with intact enterohepatic circulation. Adducts formed within enterocytes by 1 hour, translocated to the brush border, preceded ulceration and vascular protein leakage, and were intense at sites of ulceration. Adducts and ulcers exhibited a parallel distribution within intestinal quintiles: 3rd > 5th >> 1st. Conclusions: Diclofenac treatment resulted in the formation of drug adducts in enterocytes. Because this molecular change occurred before ulceration, was dose dependent, and exhibited concordant distribution with extent of ulceration, the results suggest a causal role for drug adduct formation in diclofenac enteropathy.GASTROENTEROLOGY 2000;119:1537-1547

Neurotensin elevates hepatic bile acid secretion in chickens by a mechanism requiring an intact enterohepatic circulation.

Neurotensin (NT), given intravenously at 10-50 pmol/kg per min to anesthetized female chickens equipped with a bile duct fistula, dose-dependently elevated hepatic bile flow and bile acid output but only when the enterohepatic circulation was maintained by returning the bile to the intestinal lumen. Infusion of NT at 10 and 50 pmol/kg per min increased the average hepatic bile acid output over a 30-min period to 138 +/- 11 and 188 +/- 13% of control, respectively. During infusion of NT, plasma levels of immunoreactive NT (iNT) increased in time from the basal level (14 +/- 1.3 pM) to reach steady state at 30 min. There was a near linear relationship between the dose of NT infused and the increment in plasma iNT. In addition, infusion of NT at 40 pmol/kg min gave a plasma level of iNT (approximately/= 88 pM) which was within the range of those observed during duodenal perfusion with lipid (54-300 pM) and near to that measured in hepatic portal blood from fed animals (52 +/- 5 pM). Perfusion of duodenum with lipid released endogenous NT and increased the rate of hepatic bile flow. When NT antagonist SR48692 was given, bile flow rate decreased to the basal level. These results suggest that intestinal NT, released by lipid, may participate in the regulation of hepatic bile acid output by a mechanism requiring an intact enterohepatic circulation.

Regulation of multidrug resistance 2 P-glycoprotein expression by bile salts in rats and in primary cultures of rat hepatocytes

Biliary phospholipid secretion is tightly coupled to the secretion of free cholesterol and bile salts. The secretion of phospholipids across the canalicular membrane of hepatocytes occurs via the multidrug resistance 2 (mdr2) P-glycoprotein (Pgp). The mechanism underlying the coupling of bile salt and phospholipid secretion has not been elucidated. The aims of this study were to determine the effects of bile acid structure on the expression of mdr2 in vitro and in vivo. Under optimal culture conditions, taurine-conjugated bile acids (50 μmol/L) increased mdr2 messenger RNA (mRNA) levels in the following order: taurocholate (TCA) (288 ± 36%, P < .005) = taurodeoxycholate (TDCA) (276 ± 36%, P < .025) > taurochenodeoxycholate (TCDCA) (216 ± 34%, P < .025) > tauroursodeoxycholate (TUDCA) (175 ± 28%,P < .05) of control levels. The increase in mdr2 mRNA levels by TCA was both time and concentration dependent. Cholate feeding to rats with intact enterohepatic circulation increased mdr2 transcriptional activity by 4-fold and protein mass by 1.9-fold. Chronic biliary diversion (CBD) decreased mdr2 mRNA levels to 66 ± 9% (P < .025) of sham-operated controls. Intraduodenal infusion of TCA for 48 hours in CBD rats caused a significant increase in mdr2 mRNA levels (224%) as compared with CBD controls. A diet high in cholesterol (4%) decreased mdr2 mRNA levels to 57% ± 2 (P < .001) of pair-fed controls. Squalestatin (1 μmol/L), an inhibitor of cholesterol biosynthesis, increased mdr2 mRNA levels by 8.8-fold (P < .005) in hepatocyte cultures after 24 hours. In conclusion, in the rat, bile acids up-regulated mdr2 transcriptional activity whereas cholesterol decreased mdr2 mRNA both in vitro and in vivo. (Hepatology 2000;32:341-347.)

Obstructive Jaundice, Bacterial Translocation and Interdigestive Small-Bowel Motility in Rats

Background/Aims: Translocation of gut bacteria occurs in obstructive jaundice, the underlying mechanisms are unclear. We designed this experimental study to investigate the association between interdigestive motility and the pathogenesis of bacterial translocation during biliary obstruction. Methods: Rats were fitted with jejunal myoelectrodes for the measurement of the interdigestive migrating motor complex (MMC) and with two cannulas in the proximal common bile duct (CBD) for exteriorization of biliary flow. This allowed measurement of MMCs under control conditions with an intact enterohepatic circulation and during 3 days of CBD obstruction without surgical intervention. Mesenteric lymph nodes, liver, spleen and segments of the duodenum, the jejunum and the caecum were removed for microbial culturing. Results: The MMC cycle length increased from 17.3 min before CBD obstruction to 31.9, 34.1, and 25.3 min on days 1, 2 and 3, respectively, after CBD obstruction (p < 0.05 for all days). Bacterial levels in the jejunum were significantly higher in CBD-obstructed rats than in control rats. The translocation incidence was significantly higher in rats with CBD obstruction (6/8) than in control rats (1/8). The bacterial levels in the jejunum correlated significantly with the MMC cycle length (r = 0.60, p <0.05). Conclusion: Experimental biliary obstruction is associated with disturbance of MMCs, small-bowel bacterial overgrowth and increased bacterial translocation.

Differential effects of 17α-ethinylestradiol on the neutral and acidic pathways of bile salt synthesis in the rat

Effects of 17alpha-ethinylestradiol (EE) on the neutral and acidic biosynthetic pathways of bile salt (BS) synthesis were evaluated in rats with an intact enterohepatic circulation and in rats with long-term bile diversion to induce BS synthesis. For this purpose, bile salt pool composition, synthesis of individual BS in vivo, hepatic activities, and expression levels of cholesterol 7alpha-hydroxylase (CYP7A), and sterol 27-hydroxylase (CYP27), as well as of other enzymes involved in BS synthesis, were analyzed in rats treated with EE (5 mg/kg, 3 days) or its vehicle. BS pool size was decreased by 27% but total BS synthesis was not affected by EE in intact rats. Synthesis of cholate was reduced by 68% in EE-treated rats, while that of chenodeoxycholate was increased by 60%. The recently identified Delta22-isomer of beta-muricholate contributed for 5.4% and 18.3 % (P < 0.01) to the pool in control and EE-treated rats, respectively, but could not be detected in bile after exhaustion of the pool. A clear reduction of BS synthesis was found in bile-diverted rats treated with EE, yet biliary BS composition was only minimally affected. Activity of CYP7A was decreased by EE in both intact and bile-diverted rats, whereas the activity of the CYP27 was not affected. Hepatic mRNA levels of CYP7A were significantly reduced by EE in bile-diverted rats only; CYP27 mRNA levels were not affected by EE. In addition, mRNA levels of sterol 12alpha-hydroxylase and lithocholate 6beta-hydroxylase were increased by bile diversion and suppressed by EE. This study shows that 17alpha-ethinylestradiol (EE)-induced intrahepatic cholestasis in rats is associated with selective inhibition of the neutral pathway of bile salt (BS) synthesis. Simultaneous impairment of other enzymes in the BS biosynthetic pathways may contribute to overall effects of EE on BS synthesis.

Contribution of newly synthesized cholesterol to rat plasma and bile determined by mass isotopomer distribution analysis: bile-salt flux promotes secretion of newly synthesized cholesterol into bile.

To quantify the contribution of newly synthesized cholesterol to total plasma and biliary cholesterol under physiological conditions, unrestrained rats were infused intravenously with [1-13C]acetate (0. 6mmol/h per kg) from 12:00 to 24:00 h, and fractional and absolute cholesterol-synthesis rates were determined by mass isotopomer distribution analysis (MIDA). As bile diversion leads to changes in cholesterol metabolism, rats were equipped with permanent catheters in the bile duct and duodenum, allowing sampling of small amounts of bile from an intact enterohepatic circulation. For comparison, rats with chronic bile diversion were also studied. Fractional synthesis of plasma cholesterol was 10.8+/-1.7% (mean+/-S.D.) after 12 h in rats with intact circulation. Fractional synthesis of biliary cholesterol was significantly higher than that of plasma cholesterol, i.e. 16.5+/-2.0% (P<0.05) after 12 h. In contrast, no differences between fractional synthesis of cholesterol in plasma and bile were found in bile-diverted animals (31.8+/-2.1 and 33.1+/-3.3% respectively after 12 h). The calculated absolute rate of cholesterol biosynthesis increased from 53+/-10 to 221+/-19 micromol/day per kg after bile diversion. A comparison of MIDA results with those obtained from balance studies indicated that MIDA does not assess total body synthesis in rats, presumably because of incomplete equilibration of newly synthesized molecules with cholesterol in the plasma compartment. These studies demonstrate that the contribution of newly synthesized cholesterol to biliary cholesterol is higher than to plasma cholesterol under physiological conditions, probably reflecting bile-salt-induced secretion of newly formed cholesterol by the periportal hepatocytes.

The contribution of newly synthesized cholesterol to biliary cholesterol in healthy humans.

Hypersecretion of biliary cholesterol appears to be the key defect in the pathogenesis of cholesterol gallstones, and this may be due to an enhanced synthesis of cholesterol. To measure fractional syntheses of biliary and plasma cholesterol, five male and 3 female healthy humans with an intact enterohepatic circulation were infused intravenously with [1-13C]acetate for 15 h. Samples of duodenal bile and blood were taken hourly and an enteral formula diet was given. Free cholesterol mass distribution was analyzed by gas chromatography mass spectrometry. The Mass Isotopomer Distribution Analysis (MIDA) technique allowed to calculate fractional synthesis. After 6 hours of infusion, the [13C]label of the cytosolic acetate pool reached a plateau of approximately 12%. Individual fractional cholesterol synthesis is plasma and bile correlated significantly (6-15 h) and amounted to 4.2% and 5.3% after 15 h, respectively. It may be concluded from this study, that newly synthesized cholesterol is secreted into bile to a higher extent than into plasma.

Induction of sodium-dependent bile acid transporter messenger RNA, protein, and activity in rat ileum by cholic acid

BACKGROUND & AIMS: The ileal sodium-dependent bile acid transporter reclaims bile acids from the intestinal lumen to preserve their enterohepatic recirculation. The present studies sought to determine the possible role of enteric bile acids in the molecular regulation of the apical bile acid transporter in rat ileal mucosa.METHODS: Paired rats were fed a control diet or control diet plus cholic acid (1%) or ursodeoxycholic acid (1%) for 10 days. Other paired rats underwent biliary diversion for 72 hours, followed by intraduodenal infusion of taurocholate or fluid/electrolytes. Transporter protein, messenger RNA (mRNA), and activity were determined in the distal 15 cm of ileal mucosa.RESULTS: Transporter protein and mRNA levels in cholic acid-fed rats increased approximately threefold above levels in paired rats fed the control diet (P < 0.02). Similarly, sodium-dependent [3H]taurocholate uptake into membrane vesicles from cholic acid-fed rats increased twofold above uptake into vesicles from control-fed rats because of a twofold increase in maximal transport velocity. In biliary- diverted rats (72-96 hours), transporter protein decreased to 57% +/- 5% of paired controls with intact enterohepatic circulation (P < 0.0001). The intraduodenal infusion of taurocholate (24 hours) in biliary-diverted rats resulted in a time-dependent reinduction of transporter protein expression (3.5-fold).CONCLUSIONS: The expression of the ileal apical bile acid transporter is induced at a pretranslational level by free or taurine-conjugated cholic acid within the small intestine.(Gastroenterology 1997 Nov;113(5):1599-608)

Composition and aggregational forms of biliary lipids in human bile after short-term administration of Taurohyodeoxycholic acid

Introduction: Taurohyodeoxycholic acid (THDC), a new natural hydrophilic bile salt, dissolves human cholesterol gallstones in vitro and may be effective as a litholytic agent in vivo. We thus, investigated in man the effects of short-term oral administration of THDC on lipid composition and physical-chemical features of bile. Methods: Three patients with a nasobiliary drainage (positioned after sphincterotomy for bile duct stones removal) were given 3 g of THDC (1 g every 12 h). At time of the study patients had an intact entero-hepatic circulation and minimal signs of cholestasis. Bile was collected before each THDC administration, the last sample being obtained 14 h after the final THDC dose. All specimens were analyzed for individual bile salts (HPLC) and lipids. Biliary lipid carriers were separated by gel-chromatography on Superose-6 and analyzed by quasielastic light scattering (QLS) and electron microscopy (EM). Results: biliary THDC concentration represented 30.3, 27.2 and 29.2% of total bile salts, respectively. Lecithin and cholesterol concentration in bile did not change significantly during the study. In all bile lipids were almost exclusively eluted in a single gel-chromatographic peak, with an average molecular weight between 20 and 100 kDa QLS analysis of THDC-rich biles, demonstrated an average hydrodynamic diameter of this lipid-carrier of 300 nm. In THDC-free biles fractionated using the same conditions, the predominant lipid-carrier had an average hydrodynamic diameter of 250 nm. This difference in size was confirmed at EM. Conclusions: THDC is efficiently secreted in human bile, without causing changes in the concentration of biliary lipids. The latter, however, are assembled in structures larger than those found in THDC-free biles. The size and spherical appearance of these aggregates are consistent with those of large unilamellar vesicles or multilamellar structures.

The effects of dietary phospholipids enriched with phosphatidylethanolamine on bile and red cell membrane lipids in humans.

The role of phospholipids in biliary cholesterol solubilization and crystallization has only recently begun to be appreciated. Phospholipid vesicles are believed to be the metastable carrier from which cholesterol nucleates. Cholesterol crystallization is influenced by the phospholipid species in bile. Feeding rats and hamsters with diets enriched in phospholipids or their precursors, especially ethanolamine, resulted in reduced cholesterol saturation of bile. Although whole phospholipids are normal dietary constituents, the effects and safety of phospholipid components have not been tested in humans. In the present study, we have evaluated the effects of a dietary phospholipid mixture, enriched with phosphatidylethanolamine, on human bile and red blood cell membrane lipid composition. Five ambulatory volunteers having a chronic indwelling T-tube, with an intact enterohepatic circulation, were investigated. Thirty-six grams of phospholipids (54% phosphatidylethanolamine, 54% linoleyl acyl chains) were added to their daily diet for fourteen days. Biliary nucleation time, cholesterol carriers, as well as plasma, red blood cell membrane, and bile lipid compositions, were monitored. Following phospholipid supplementation, the proportion of linoleyl chains (18:2) in biliary phospholipids increased significantly from 31.1 +/- 1.2 to 37.7 +/- 5.3%, while that of oleyl chains (18:1) decreased from 11.4 +/- 1.6 to 9.6 +/- 1.1%. These changes were accompanied by an increase of linoleate and its metabolite, arachidonate, in red cell membranes. Phospholipid feeding did not cause any side effects, and no significant changes in biliary nucleation time, cholesterol, phospholipid, or bile salt concentrations, or in the distribution of cholesterol within micelles or vesicles. We conclude that phospholipid feeding is safe, and can be effective as a vehicle for lecithin fatty acyl chain modulation of bile and lipid membranes. These findings may provide a basis for a controlled modulation of biliary phospholipids to increase cholesterol solubility in bile.