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Krupa Ł, Staroń R, Dulko D, et al. Importance of Bile Composition for Diagnosis of Biliary Obstructions. Molecules. 2021;26(23)doi: 10.3390/molecules26237279.
Krupa, �. �., Staroń, R., Dulko, D., Łozińska, N., Mackie, A. R., Rigby, N. M., Macierzanka, A., Markiewicz, A., & Jungnickel, C. (2021). Importance of Bile Composition for Diagnosis of Biliary Obstructions. Molecules (Basel, Switzerland), 26(23), . https://doi.org/10.3390/molecules26237279
Krupa, Łukasz, et al. "Importance of Bile Composition for Diagnosis of Biliary Obstructions." Molecules (Basel, Switzerland) vol. 26,23 (2021). doi: https://doi.org/10.3390/molecules26237279
Krupa Ł, Staroń R, Dulko D, Łozińska N, Mackie AR, Rigby NM, Macierzanka A, Markiewicz A, Jungnickel C. Importance of Bile Composition for Diagnosis of Biliary Obstructions. Molecules. 2021 Nov 30;26(23). doi: 10.3390/molecules26237279. PMID: 34885858; PMCID: PMC8659177.
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Molecules. 2021 Nov 30;26(23). doi: 10.3390/molecules26237279.

Importance of Bile Composition for Diagnosis of Biliary Obstructions.

Molecules (Basel, Switzerland)

Łukasz Krupa, Robert Staroń, Dorota Dulko, Natalia Łozińska, Alan R Mackie, Neil M Rigby, Adam Macierzanka, Aleksandra Markiewicz, Christian Jungnickel

Affiliations

  1. Teaching Hospital No 1, Department of Gastroenterology and Hepatology with Internal Disease Unit, Chopina 2, 35-055 Rzeszów, Poland.
  2. Medical Department, University of Rzeszów, Kopisto 2a, 35-310 Rzeszów, Poland.
  3. Department of Colloid and Lipid Science, Faculty of Chemistry, Gda?sk University of Technology, Narutowicza 11/12, 80-233 Gda?sk, Poland.
  4. School of Food Science & Nutrition, University of Leeds, Leeds LS2 9JT, UK.
  5. Laboratory of Translational Oncology Intercollegiate, Faculty of Biotechnology, University of Gda?sk and Medical University of Gda?sk, 80-211 Gda?sk, Poland.

PMID: 34885858 PMCID: PMC8659177 DOI: 10.3390/molecules26237279

Abstract

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.

Keywords: biliary obstruction; bilirubin; cholangiocarcinoma; choledocholithiasis; conjugated/unconjugated bile salts; pancreatic neoplasm

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