Significance Of β-glucuronidase In The Formation Of Gallbladder Stone

Objective: There are endogenous and bacterial β-Glucuronidases(β-G) in the bile. β-G can split the conjugated bilirubin into glucuronic acid and unconjugated bilirubin (UCB) in bile, the latter is one of the major components of gallstone. β-G play an important role in the formation of pigment stone in bile duct. The authors investigated the difference of total bilirubin content (TB) , UCB content and the activities of β-G in the gallbladder bile of three groups to confirm whether β-G is responsible for the formation of gallbladder cholesterol stone ,and also to analyse the relationship between endogenous and bacterial β-G in the formation of the stone. Methods The gallbladder bile was collected from 28 patients who underwent cholecystectomy in the department of general surgery in the First Affiliated Hospital of AnHui Medical University. Based on the diagnosis, they were divided into three groups: gallbladder polypus (PO), chronic cholecystitis with calculus (CI) and acute cholecystitis with calculus (AI) .Five were male and six were female, the age range was 30~71 years in PO. Five were male and six were female ,the age range was 28~ 72 years in CI. Three were male and three were female, the age range was 32~68 years in CI. All the patients with hepatitis or malignant tomour were excluded. The pathological finding showed that lymphocytes and monocytes were obviously seen in CI,but neutrophils in AI. Bile were collected for the detection of TB, UCB and the activities of β-G.The gallstone were collected for the distinction of stone-types.The bottom of gallbladder were sampled for HE dye to determine pathological changes of gallbladder. UCB/TB and the total activities of β-G were Calculated for analysis. Age,sex and liver-kidney function were collected for analysis with data above. Resu I ts TB,UCB/TB and the activities of endogenous ,bacterial and total β-G were significantly different in three groups (P<0.05) , UCB was not different. UCB/TB,theactivities of endogenous , bacterial and total -G in the bile from CI was obviously higher than that in PO (P<0.05 ) , but the level of total bilirubin was reverse in the two groups (P<0.05) ,UCB was not different, and so did the changes in AI and CI except that UCB/TB was not different in two groups. The levels of endogenous ,bacterial and total β-G were positively correlated respectively (P<0.05) .All gallstone is cholesterol stone. ALT were positively correlated to the activities of endogenous , bacterial and total β-G in the bile. Conclusion There are pathological elevation of β-G in gallbladder bile with calculus (P<0.05) , and the levels of endogenous β-G were positive related to the levels of bacterial β-G because of infection (P<0.05) .TB was decreased by the hydrolyzation of β-G (P<0.05 ) ,and UCB has a descending tendency. ALT were positively correlated with the activities of -G,which is the physiological reaction of liver to infection.In conclusion, -Glucuronidase could accelerate the hydrolyzation of BDG and the formation of UCB,the latter could promote the formation of gallstone by certain unknown mechanism. β-G may be responsible for the formation of gallbladder cholesterol stone.