Publication: Microstructural analysis of bile: relevance to cholesterol gallstone pathogenesis
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Date
2000
Authors
Rubin, M. ; Pakula, R. ; Konikoff, F.M.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
The study of physical-chemical factors and
pathways leading to cholesterol crystallization in bile
has important clinical relevance. The major processes in
cholesterol gallstone formation can be subdivided into
nucleation, formation and precipitation of solid crystals
(crystallization), crystal growth, crystal agglomeration
and stone growth. A clear understanding of the
microstructural events occurring during the earliest
stages of these processes in bile is crucial for the
identification of factors possibly delaying or preventing
precipitation of cholesterol crystals and, therefore,
gallstone formation in bile.
Detection and characterization of microstructures in
native and model biles can be achieved by both direct
and indirect techniques. Direct imaging techniques
provide more readily interpretable information, but
sample preparation problems, particularly for electron
microscopy, are a source of artifacts. Moreover,
microscopic techniques provide only qualitative data
without the possibility to quantitate or to analyse the
composition of microstructures. Several indirect
techniques have been used to obtain additional
microstructural information about nucleating bile. These
techniques have the disadvantage of often being model
dependent in addition to constraints specific for each
method.
The systematic, judicious use of a combination of complementary direct and indirect techniques have led
to a comprehensive understanding of the various
microstructural processes and interactions occurring
during bile secretion, flow in the biliary tract and storage
in the gallbladder. This forms the basis for our current
understanding of cholesterol nucleation, crystallization
and gallstone formation.
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