胆固醇结石病人胆汁免疫球蛋白含量增高及其对胆固醇-磷脂泡的影响

Effect of increased billiary immunoglobulins on formation of cholesterol-phospholipid vesicle in patients with cholesterol gallstone

目的 :研究胆固醇结石病人胆囊胆汁、胆总管胆汁、血清3种免疫球蛋白(immunoglobulin,Ig)含量及其对胆固醇-磷脂泡变化的影响。方法:通过Con A亲和层析与Sephadex G-200分子筛凝胶两次过滤,从胆囊胆固醇结石病人及胆囊胆色素结石病人、无结石对照病人、非结石急性胆囊炎病人以及白胆汁病人胆囊胆汁、胆总管胆汁和血清中分离提纯Ig A、Ig G和Ig M;应用单向免疫扩散法检测3种Ig含量;应用电子显微镜观察Ig在模拟胆汁体系对胆固醇-磷脂泡的影响。结果:胆固醇结石组胆囊胆汁含有较高浓度的Ig G和Ig M,胆总管胆汁的3种Ig含量增高。胆色素结石组胆总管胆汁Ig A、Ig M含量与对照组无差异。胆固醇结石组和胆色素结石组除血清Ig A含量低于对照组外,其余Ig含量与对照组无差异。胆固醇结石组胆囊胆汁Ig G和Ig M分别作用于模拟胆汁7 d,明显促使单层泡直径增大,且增加多层泡数量;而Ig A仅轻微增加单层泡直径,不影响多层泡数量。结论:本实验结果显示,胆固醇结石组胆汁中Ig增高,可能通过影响胆固醇-磷脂泡变化,促进胆固醇结石形成。

Objective To study the contents of Ig A, Ig G or Ig M from both bile and serum in the patients with cholesterol gallstone and control groups, and the effect of immunoglobulin on cholesterol-phospholipid vesicles. Methods Ig A, Ig G and Ig M were purified by affinity chromatography using Con A-sepharose, and（twice） Sephadex G-200 gel filtration from bile and serum. The content of Ig A, Ig G or Ig M was determined by immunodiffusion assay. The alteration of cholesterol-phospholipid vesicles was observed under electron microscopy. Results The content of Ig G and Ig M from gallbladder bile in cholesterol gallstone group was much higher, compared with that of control groups. The content of Ig A, Ig G and Ig M from common bile duct bile in cholesterol gallstone group also increased. However, the content of Ig A and Ig M from common bile duct bile in pigment gallstone group was same as control groups. No differences were found between the groups in the content of immunoglobulins in serum except for lower content of Ig A in group of cholesterol gallstone and pigment gallstone. Either Ig G or Ig M added in model bile for 7 day enlarged obviously the diameter of cholesterol-phospholipid monolayer vesicles and increased the numbers of cholesterol-phospholipid multilayer vesicles. Ig A enlarged slightly the diameter of cholesterol-phospholipid monolayer vesicles, but did not affect the number of cholesterolphospholipid multilayer vesicles. Conclusions The increased content of Ig A, Ig G and Ig M may facilitate the cholesterol gallstone formation through altering the cholesterol-phospholipid vesicles.