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Chemical characterization of gallstones: an approach to explore the aetiopathogenesis of gallstone disease in Sri Lanka.

Weerakoon H, Navaratne A, Ranasinghe S, Sivakanesan R, Galketiya KB, Rosairo S - PLoS ONE (2015)

Bottom Line: All the patients had primary gallbladder stones.Only 10 (9%) had pure cholesterol gallstones.Hence it is imperative to explore this further to understand the aetiopathogenesis of GS among Sri Lankans.

View Article: PubMed Central - PubMed

Affiliation: Department of Biochemistry, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka; Post Graduate Institute of Science, University of Peradeniya, Peradeniya, Sri Lanka.

ABSTRACT

Introduction: Records on gallstones and associated ailments in Sri Lankan community are scarce, despite frequent detection of gallstone disease. Identification of the chemical composition of gallstones in the local setting is important in defining aetiopathogenic factors which in turn are useful in implementing therapeutic and preventive strategies. This study aimed to describe the chemical composition of gallstones and the socio-demographic factors of a cohort of Sri Lankan patients with gallstone disease.

Materials and methods: Data on clinical and socio-demographic factors, and gallstones removed at surgery were collected from patients with cholelithiasis admitted to Teaching Hospital, Peradeniya, Sri Lanka from May 2011 to December 2012. External and cross sectional morphological features of gallstones were recorded by naked eye observation. Compositional analysis was carried out by Fourier Transform Infrared Spectroscopy, X - ray Powder Diffraction, and Atomic Absorption Spectrophotometry. Scanning Electron Microscopy was used to identify the microstructure of gallstones.

Results: Data of 102 patients were analyzed. Of them majority (n = 77, 76%) were females with a female: male ratio of 3:1. Mean age of the study group was 46.1±11.6 years. All the patients had primary gallbladder stones. According to the physical and chemical analysis, majority (n = 54, 53%) were pigment gallstones followed by mixed cholesterol gallstones (n = 38, 37%). Only 10 (9%) had pure cholesterol gallstones. Calcium bilirubinate, calcium carbonate and calcium phosphate were the commonest calcium salts identified in pigment gallstones and core of mixed cholesterol gallstones.

Conclusion: Presence of a pigment nidus in gallstones is a common feature in majority of Sri Lankan patients denoting the possible role of elevated unconjugated bilirubin in bile on the pathogenesis of GS. Hence it is imperative to explore this further to understand the aetiopathogenesis of GS among Sri Lankans.

No MeSH data available.


Related in: MedlinePlus

A typical FTIR spectrogram of five gallstone types.A—Pure cholesterol stone and pale areas of mixed cholesterol stone composed of cholesterol (1465, 1381, and 1056 cm-1). B—Pigmented areas of mixed cholesterol stone composed of calcium bilirubinate (1658, 1631, 1573 and 1249 cm-1), calcium carbonate (1462, 871 and 698 cm-1) and calcium phosphate (1026, 606 and 505 cm-1). C—Pigment stone composed of calcium bilirubinate (1658, 1627, 1566 and 1249 cm-1). D—Pigment stone composed of calcium bilirubinate (1658, 1627, 1566 and 1249 cm-1), calcium carbonate (1450, 694 1658, 1627, 1566 and 1249 cm-1) and calcium phosphate (1080, 1033, 609 and 547 cm-1). E—Pigment stone composed of calcium bilirubinate (1666, 1620, 1573 and 1249 cm-1) and calcium palmitate (2916, 2846, 1543, 1103 and 756 cm-1).
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pone.0121537.g002: A typical FTIR spectrogram of five gallstone types.A—Pure cholesterol stone and pale areas of mixed cholesterol stone composed of cholesterol (1465, 1381, and 1056 cm-1). B—Pigmented areas of mixed cholesterol stone composed of calcium bilirubinate (1658, 1631, 1573 and 1249 cm-1), calcium carbonate (1462, 871 and 698 cm-1) and calcium phosphate (1026, 606 and 505 cm-1). C—Pigment stone composed of calcium bilirubinate (1658, 1627, 1566 and 1249 cm-1). D—Pigment stone composed of calcium bilirubinate (1658, 1627, 1566 and 1249 cm-1), calcium carbonate (1450, 694 1658, 1627, 1566 and 1249 cm-1) and calcium phosphate (1080, 1033, 609 and 547 cm-1). E—Pigment stone composed of calcium bilirubinate (1666, 1620, 1573 and 1249 cm-1) and calcium palmitate (2916, 2846, 1543, 1103 and 756 cm-1).

Mentions: The chemical compositions of different types GS as revealed by FTIR are shown in Table 1 and the patterns of FTIR spectra obtained for different types of GS are given in Fig 2. According to the analysis, majority of GS (n = 69, 68%) were composed of multiple chemical compounds, while only 33 (32%) of GS were composed only of single compound. Calcium bilirubinate, calcium carbonate and calcium phosphate are the frequently identified calcium salts in the GS samples whereas calcium palmitate was detected only in 6 (6%) pigment GS (Fig 2E). Further the chemical analysis of the core of mixed cholesterol GS (Fig 2B), which had heterogeneous morphology in cross section, revealed the presence of calcium bilirubinate, calcium carbonate and calcium phosphate.


Chemical characterization of gallstones: an approach to explore the aetiopathogenesis of gallstone disease in Sri Lanka.

Weerakoon H, Navaratne A, Ranasinghe S, Sivakanesan R, Galketiya KB, Rosairo S - PLoS ONE (2015)

A typical FTIR spectrogram of five gallstone types.A—Pure cholesterol stone and pale areas of mixed cholesterol stone composed of cholesterol (1465, 1381, and 1056 cm-1). B—Pigmented areas of mixed cholesterol stone composed of calcium bilirubinate (1658, 1631, 1573 and 1249 cm-1), calcium carbonate (1462, 871 and 698 cm-1) and calcium phosphate (1026, 606 and 505 cm-1). C—Pigment stone composed of calcium bilirubinate (1658, 1627, 1566 and 1249 cm-1). D—Pigment stone composed of calcium bilirubinate (1658, 1627, 1566 and 1249 cm-1), calcium carbonate (1450, 694 1658, 1627, 1566 and 1249 cm-1) and calcium phosphate (1080, 1033, 609 and 547 cm-1). E—Pigment stone composed of calcium bilirubinate (1666, 1620, 1573 and 1249 cm-1) and calcium palmitate (2916, 2846, 1543, 1103 and 756 cm-1).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4390354&req=5

pone.0121537.g002: A typical FTIR spectrogram of five gallstone types.A—Pure cholesterol stone and pale areas of mixed cholesterol stone composed of cholesterol (1465, 1381, and 1056 cm-1). B—Pigmented areas of mixed cholesterol stone composed of calcium bilirubinate (1658, 1631, 1573 and 1249 cm-1), calcium carbonate (1462, 871 and 698 cm-1) and calcium phosphate (1026, 606 and 505 cm-1). C—Pigment stone composed of calcium bilirubinate (1658, 1627, 1566 and 1249 cm-1). D—Pigment stone composed of calcium bilirubinate (1658, 1627, 1566 and 1249 cm-1), calcium carbonate (1450, 694 1658, 1627, 1566 and 1249 cm-1) and calcium phosphate (1080, 1033, 609 and 547 cm-1). E—Pigment stone composed of calcium bilirubinate (1666, 1620, 1573 and 1249 cm-1) and calcium palmitate (2916, 2846, 1543, 1103 and 756 cm-1).
Mentions: The chemical compositions of different types GS as revealed by FTIR are shown in Table 1 and the patterns of FTIR spectra obtained for different types of GS are given in Fig 2. According to the analysis, majority of GS (n = 69, 68%) were composed of multiple chemical compounds, while only 33 (32%) of GS were composed only of single compound. Calcium bilirubinate, calcium carbonate and calcium phosphate are the frequently identified calcium salts in the GS samples whereas calcium palmitate was detected only in 6 (6%) pigment GS (Fig 2E). Further the chemical analysis of the core of mixed cholesterol GS (Fig 2B), which had heterogeneous morphology in cross section, revealed the presence of calcium bilirubinate, calcium carbonate and calcium phosphate.

Bottom Line: All the patients had primary gallbladder stones.Only 10 (9%) had pure cholesterol gallstones.Hence it is imperative to explore this further to understand the aetiopathogenesis of GS among Sri Lankans.

View Article: PubMed Central - PubMed

Affiliation: Department of Biochemistry, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka; Post Graduate Institute of Science, University of Peradeniya, Peradeniya, Sri Lanka.

ABSTRACT

Introduction: Records on gallstones and associated ailments in Sri Lankan community are scarce, despite frequent detection of gallstone disease. Identification of the chemical composition of gallstones in the local setting is important in defining aetiopathogenic factors which in turn are useful in implementing therapeutic and preventive strategies. This study aimed to describe the chemical composition of gallstones and the socio-demographic factors of a cohort of Sri Lankan patients with gallstone disease.

Materials and methods: Data on clinical and socio-demographic factors, and gallstones removed at surgery were collected from patients with cholelithiasis admitted to Teaching Hospital, Peradeniya, Sri Lanka from May 2011 to December 2012. External and cross sectional morphological features of gallstones were recorded by naked eye observation. Compositional analysis was carried out by Fourier Transform Infrared Spectroscopy, X - ray Powder Diffraction, and Atomic Absorption Spectrophotometry. Scanning Electron Microscopy was used to identify the microstructure of gallstones.

Results: Data of 102 patients were analyzed. Of them majority (n = 77, 76%) were females with a female: male ratio of 3:1. Mean age of the study group was 46.1±11.6 years. All the patients had primary gallbladder stones. According to the physical and chemical analysis, majority (n = 54, 53%) were pigment gallstones followed by mixed cholesterol gallstones (n = 38, 37%). Only 10 (9%) had pure cholesterol gallstones. Calcium bilirubinate, calcium carbonate and calcium phosphate were the commonest calcium salts identified in pigment gallstones and core of mixed cholesterol gallstones.

Conclusion: Presence of a pigment nidus in gallstones is a common feature in majority of Sri Lankan patients denoting the possible role of elevated unconjugated bilirubin in bile on the pathogenesis of GS. Hence it is imperative to explore this further to understand the aetiopathogenesis of GS among Sri Lankans.

No MeSH data available.


Related in: MedlinePlus