Original Article
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World J Gastroenterol. Sep 7, 2013; 19(33): 5454-5463
Published online Sep 7, 2013. doi: 10.3748/wjg.v19.i33.5454
Biliary phosphatidylcholine and lysophosphatidylcholine profiles in sclerosing cholangitis
Annika Gauss, Robert Ehehalt, Wolf-Dieter Lehmann, Gerhard Erben, Karl-Heinz Weiss, Yvonne Schaefer, Petra Kloeters-Plachky, Adolf Stiehl, Wolfgang Stremmel, Peter Sauer, Daniel Nils Gotthardt
Annika Gauss, Robert Ehehalt, Karl-Heinz Weiss, Yvonne Schaefer, Petra Kloeters-Plachky, Adolf Stiehl, Wolfgang Stremmel, Peter Sauer, Daniel Nils Gotthardt, Gastroenterology and Hepatology Unit, Department of Internal Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
Wolf-Dieter Lehmann, Gerhard Erben, Department of Spectroscopy, German Cancer Research Center, 69120 Heidelberg, Germany
Author contributions: Gauss A and Gotthardt DN designed the research; Gauss A, Gotthardt DN, Schaefer Y, Erben G and Kloeters-Plachky P performed the research; Lehmann WD, Sauer P, Stiehl A, Ehehalt R, Weiss KH and Stremmel W contributed to analysis and interpretation of data; Gauss A and Gotthardt DN wrote the paper; Gauss A, Ehehalt R, Lehmann WD, Erben G, Weiss KH, Schaefer Y, Kloeters-Plachky P, Stiehl A, Stremmel W, Sauer P and Gotthardt DN revised the manuscript critically for important intellectual content.
Supported by A Grant from Deutsche Forschungsgemeinschaft (DFG)
Correspondence to: Annika Gauss, MD, Gastroenterology and Hepatology Unit, Department of Internal Medicine, University Hospital Heidelberg, INF 410, Heidelberg 69120, Germany. annika.gauss@med.uni-heidelberg.de
Telephone: +49-6221-5638865 Fax: +49-6221-565255
Received: March 31, 2013
Revised: June 8, 2013
Accepted: July 17, 2013
Published online: September 7, 2013
Abstract

AIM: To analyze phospholipid profiles in intrahepatic bile from patients with primary sclerosing cholangitis (PSC) and secondary sclerosing cholangitis (SSC).

METHODS: Intrahepatic bile specimens collected via endoscopic retrograde cholangiography from 41 patients were analyzed. Fourteen of these patients were diagnosed with PSC, 10 with SSC, 11 with choledocholithiasis or no identifiable biliary disease, and 6 with cholangiocellular carcinoma (CCC). Bile acid, cholesterol, protein, and bilirubin contents as well as pancreas lipase activity in bile were determined by biochemical methods. Phosphatidylcholine (PC) and lysophosphatidylcholine (LPC) species were quantified using nano-electrospray ionization tandem mass spectrometry.

RESULTS: Bile from all the examined patient groups showed a remarkably similar PC and LPC species composition, with only minor statistical differences. Total biliary PC concentrations were highest in controls (8030 ± 1843 μmol/L) and lowest in patients with CCC (1969 ± 981 μmol/L) (P = 0.005, controls vs SSC and CCC, respectively, P < 0.05). LPC contents in bile were overall low (4.2% ± 1.8%). Biliary LPC/PC ratios and ratios of biliary PC to bilirubin, PC to cholesterol, PC to protein, and PC to bile acids showed no intergroup differences.

CONCLUSION: PC and LPC profiles being similar in patients with or without sclerosing cholangitis, these phospholipids are likely not of major pathogenetic importance in this disease group.

Keywords: Primary sclerosing cholangitis, Secondary sclerosing cholangitis, Cholangiocellular carcinoma, Phosphatidylcholine, Lysophosphatidylcholine, Bile, Mass spectrometry

Core tip: Based on the idea that unfavorable alterations of biliary phospholipids might play a role in the pathogenesis of sclerosing cholangitis, phosphatidylcholine (PC) and lysophosphatidylcholine (LPC) species profiles were analyzed in endoscopically-acquired intrahepatic bile using nano-electrospray ionization tandem mass spectrometry. The examination of specimens from 14 patients with primary sclerosing cholangitis, 10 patients with secondary sclerosing cholangitis, 11 patients with choledocholithiasis/no biliary disease and 6 patients with cholangiocellular carcinoma revealed strikingly similar PC and LPC species patterns, implicating at the most a minor role of biliary phospholipid changes in sclerosing cholangitis.