Importance of Bile Composition for Diagnosis of Biliary Obstructions
Determination of the cause of a biliary obstruction is often inconclusive from serum analysis alone without further clinical tests. To this end, serum markers as well as the composition of bile of 74 patients with biliary obstructions were determined to improve the diagnoses. The samples were collec...
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| Format: | Article |
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MDPI AG
2021-11-01
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| Series: | Molecules |
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| Online Access: | https://www.mdpi.com/1420-3049/26/23/7279 |
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| author | Łukasz Krupa Robert Staroń Dorota Dulko Natalia Łozińska Alan R. Mackie Neil M. Rigby Adam Macierzanka Aleksandra Markiewicz Christian Jungnickel |
| author_facet | Łukasz Krupa Robert Staroń Dorota Dulko Natalia Łozińska Alan R. Mackie Neil M. Rigby Adam Macierzanka Aleksandra Markiewicz Christian Jungnickel |
| author_sort | Łukasz Krupa |
| collection | DOAJ |
| description | Determination of the cause of a biliary obstruction is often inconclusive from serum analysis alone without further clinical tests. To this end, serum markers as well as the composition of bile of 74 patients with biliary obstructions were determined to improve the diagnoses. The samples were collected from the patients during an endoscopic retrograde cholangiopancreatography (ERCP). The concentration of eight bile salts, specifically sodium cholate, sodium glycocholate, sodium taurocholate, sodium glycodeoxycholate, sodium chenodeoxycholate, sodium glycochenodeoxycholate, sodium taurodeoxycholate, and sodium taurochenodeoxycholate as well as bile cholesterol were determined by HPLC-MS. Serum alanine aminotransferase (ALT), aspartate transaminase (AST), and bilirubin were measured before the ERCP. The aim was to determine a diagnostic factor and gain insights into the influence of serum bilirubin as well as bile salts on diseases. Ratios of conjugated/unconjugated, primary/secondary, and taurine/glycine conjugated bile salts were determined to facilitate the comparison to literature data. Receiver operating characteristic (ROC) curves were determined, and the cut-off values were calculated by determining the point closest to (0,1). It was found that serum bilirubin was a good indicator of the type of biliary obstruction; it was able to differentiate between benign obstructions such as choledocholithiasis (at the concentration of >11 µmol/L) and malignant changes such as pancreatic neoplasms or cholangiocarcinoma (at the concentration of >59 µmol/L). In addition, it was shown that conjugated/unconjugated bile salts confirm the presence of an obstruction. With lower levels of conjugated/unconjugated bile salts the possibility for inflammation and, thus, neoplasms increase. |
| first_indexed | 2024-03-10T04:47:13Z |
| format | Article |
| id | doaj.art-465a535698c14fc2b3cdb7b7921e4166 |
| institution | Directory Open Access Journal |
| issn | 1420-3049 |
| language | English |
| last_indexed | 2024-03-10T04:47:13Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Molecules |
| spelling | doaj.art-465a535698c14fc2b3cdb7b7921e41662023-11-23T02:50:04ZengMDPI AGMolecules1420-30492021-11-012623727910.3390/molecules26237279Importance of Bile Composition for Diagnosis of Biliary ObstructionsŁukasz Krupa0Robert Staroń1Dorota Dulko2Natalia Łozińska3Alan R. Mackie4Neil M. Rigby5Adam Macierzanka6Aleksandra Markiewicz7Christian Jungnickel8Teaching Hospital No 1, Department of Gastroenterology and Hepatology with Internal Disease Unit, Chopina 2, 35-055 Rzeszów, PolandTeaching Hospital No 1, Department of Gastroenterology and Hepatology with Internal Disease Unit, Chopina 2, 35-055 Rzeszów, PolandDepartment of Colloid and Lipid Science, Faculty of Chemistry, Gdańsk University of Technology, Narutowicza 11/12, 80-233 Gdańsk, PolandDepartment of Colloid and Lipid Science, Faculty of Chemistry, Gdańsk University of Technology, Narutowicza 11/12, 80-233 Gdańsk, PolandSchool of Food Science & Nutrition, University of Leeds, Leeds LS2 9JT, UKSchool of Food Science & Nutrition, University of Leeds, Leeds LS2 9JT, UKDepartment of Colloid and Lipid Science, Faculty of Chemistry, Gdańsk University of Technology, Narutowicza 11/12, 80-233 Gdańsk, PolandLaboratory of Translational Oncology Intercollegiate, Faculty of Biotechnology, University of Gdańsk and Medical University of Gdańsk, 80-211 Gdańsk, PolandDepartment of Colloid and Lipid Science, Faculty of Chemistry, Gdańsk University of Technology, Narutowicza 11/12, 80-233 Gdańsk, PolandDetermination of the cause of a biliary obstruction is often inconclusive from serum analysis alone without further clinical tests. To this end, serum markers as well as the composition of bile of 74 patients with biliary obstructions were determined to improve the diagnoses. The samples were collected from the patients during an endoscopic retrograde cholangiopancreatography (ERCP). The concentration of eight bile salts, specifically sodium cholate, sodium glycocholate, sodium taurocholate, sodium glycodeoxycholate, sodium chenodeoxycholate, sodium glycochenodeoxycholate, sodium taurodeoxycholate, and sodium taurochenodeoxycholate as well as bile cholesterol were determined by HPLC-MS. Serum alanine aminotransferase (ALT), aspartate transaminase (AST), and bilirubin were measured before the ERCP. The aim was to determine a diagnostic factor and gain insights into the influence of serum bilirubin as well as bile salts on diseases. Ratios of conjugated/unconjugated, primary/secondary, and taurine/glycine conjugated bile salts were determined to facilitate the comparison to literature data. Receiver operating characteristic (ROC) curves were determined, and the cut-off values were calculated by determining the point closest to (0,1). It was found that serum bilirubin was a good indicator of the type of biliary obstruction; it was able to differentiate between benign obstructions such as choledocholithiasis (at the concentration of >11 µmol/L) and malignant changes such as pancreatic neoplasms or cholangiocarcinoma (at the concentration of >59 µmol/L). In addition, it was shown that conjugated/unconjugated bile salts confirm the presence of an obstruction. With lower levels of conjugated/unconjugated bile salts the possibility for inflammation and, thus, neoplasms increase.https://www.mdpi.com/1420-3049/26/23/7279bilirubinconjugated/unconjugated bile saltsbiliary obstructionpancreatic neoplasmcholangiocarcinomacholedocholithiasis |
| spellingShingle | Łukasz Krupa Robert Staroń Dorota Dulko Natalia Łozińska Alan R. Mackie Neil M. Rigby Adam Macierzanka Aleksandra Markiewicz Christian Jungnickel Importance of Bile Composition for Diagnosis of Biliary Obstructions Molecules bilirubin conjugated/unconjugated bile salts biliary obstruction pancreatic neoplasm cholangiocarcinoma choledocholithiasis |
| title | Importance of Bile Composition for Diagnosis of Biliary Obstructions |
| title_full | Importance of Bile Composition for Diagnosis of Biliary Obstructions |
| title_fullStr | Importance of Bile Composition for Diagnosis of Biliary Obstructions |
| title_full_unstemmed | Importance of Bile Composition for Diagnosis of Biliary Obstructions |
| title_short | Importance of Bile Composition for Diagnosis of Biliary Obstructions |
| title_sort | importance of bile composition for diagnosis of biliary obstructions |
| topic | bilirubin conjugated/unconjugated bile salts biliary obstruction pancreatic neoplasm cholangiocarcinoma choledocholithiasis |
| url | https://www.mdpi.com/1420-3049/26/23/7279 |
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