Importance of Bile Composition for Diagnosis of Biliary Obstructions
| Autor: | Dorota Dulko, Robert Staroń, Neil M. Rigby, Adam Macierzanka, Aleksandra Markiewicz, Łukasz Krupa, Natalia Łozińska, Christian Jungnickel, Alan R. Mackie |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Taurine bilirubin conjugated/unconjugated bile salts biliary obstruction pancreatic neoplasm cholangiocarcinoma choledocholithiasis Bilirubin Sodium Pharmaceutical Science Aspartate transaminase chemistry.chemical_element Organic chemistry Gastroenterology digestive system Article Analytical Chemistry Bile Acids and Salts chemistry.chemical_compound QD241-441 Internal medicine Drug Discovery medicine Humans Aspartate Aminotransferases Physical and Theoretical Chemistry Sodium Cholate Aged Endoscopic retrograde cholangiopancreatography Cholestasis biology medicine.diagnostic_test Cholesterol Alanine Transaminase chemistry ROC Curve Chemistry (miscellaneous) Glycine biology.protein Molecular Medicine |
| Zdroj: | Molecules Molecules, Vol 26, Iss 7279, p 7279 (2021) Molecules; Volume 26; Issue 23; Pages: 7279 |
| ISSN: | 1420-3049 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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