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Effects of Ursodeoxycholic Acid Therapy on In Vitro Gallbladder Contractility in Patients with Cholesterol Gallstones

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Abstract

During treatment with ursodeoxycholic acid(UDCA), the fasting gallbladder volume increases by ayet unknown mechanism. The present study tests whetherin vitro human gallbladder contractility in response to acetylcholine and cholecystokinin isaffected by UDCA therapy. Gallbladder tissue wasobtained from 15 patients treated with UDCA (10mg/kg/day) during three weeks prior to surgery, and from15 comparable patients not treated. Data were correlated within vivo contractility, bile composition, and gallbladderwall inflammation. The inflammation score was lower inthe treated patient group. UDCA treatment enhanced gallbladder contractility in vitro:Dose-response curves for acetylcholine andcholecystokinin were both shifted to the left, and themaximal contractile stress generated in response tocholecystokinin was higher in the treated group, whereas themaximal acetylcholine-induced stress was not increased.Maximal cholecystokinin-induced stress correlatedpositively with fasting gallbladder volume andnegatively with the biliary cholesterol saturation index,but not with bile salt hydrophobicity or gallbladderwall inflammation score. In conclusion, UDCA treatmentimproves in vitro gallbladder contractility, possibly related to a reduced biliary cholesterolsaturation. Increased fasting gallbladder volumes duringUDCA treatment thus do not appear to result fromdecreased gallbladder muscle contractilestrength.

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Authors
  1. Bert J. M. Van De Heijning
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  2. Paul C. Van De Meeberg
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  3. Piero Portincasa
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  4. Heleen Doornewaard
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  5. Frank J.P. Hoebers
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  6. Karel J. Van Erpecum
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  7. Gerard P. Vanberge-Henegouwen
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Van De Heijning, B.J.M., Van De Meeberg, P.C., Portincasa, P. et al. Effects of Ursodeoxycholic Acid Therapy on In Vitro Gallbladder Contractility in Patients with Cholesterol Gallstones. Dig Dis Sci 44, 190–196 (1999). https://doi.org/10.1023/A:1026635124115

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