In vivo evidence for transintestinal cholesterol efflux in patients with complete common bile duct obstruction.

François Moreau, Claire Blanchard, Christophe Perret, Laurent Flet, Frédéric Douane, Eric Frampas, Eric Mirallie, Mikael Croyal, Audrey Aguesse, Michel Krempf, Xavier Prieur, Matthieu Pichelin, Bertrand Cariou, Cédric Le May

Journal: Journal of clinical lipidology 2020;13(1):213-217.e1

PMID: 30342919

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Beyond the hepatobiliary pathway, studies have demonstrated that direct transintestinal cholesterol efflux (TICE) of plasma-derived cholesterol may contribute to reverse cholesterol transport. The clinical evidence of TICE in human remains challenged because of the difficulty to discriminate the hepatobiliary and transintestinal routes in vivo.

OBJECTIVE

To provide the first proof of concept that TICE exists in vivo in humans by demonstrating that plasma labeled cholesterol can be excreted in the feces of patients with complete bile duct obstruction.

METHODS

Plasma, bile, and fecal cholesterol excretion was measured by mass spectrometry 24, 48, and 72 hours after intravenous injection of D7-cholesterol in two patients presenting cholangiocarcinomas with a total obstruction of their primary bile duct.

RESULTS

No trace of bile acids was detected in the feces of the two patients. Despite this, a significant amount of plasma D7-cholesterol was quantified in the feces of the two patients 48 hours and 72 hours after the intravenous injection.

CONCLUSION

Our data bring a direct proof that TICE is an active pathway in humans.

Address: L'institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France.; L'institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France; Service de Clinique de Chirurgie Digestive et Endocrinienne, CHU de Nantes, France.; Department of Radiology, CHU Nantes, Nantes, France.; Pharmacie, CHU Hôtel Dieu, Nantes Cedex, France.; Service de Clinique de Chirurgie Digestive et Endocrinienne, CHU de Nantes, France.; INRA, UMR 1280, Physiologie des Adaptations Nutritionnelles, CHU Nantes, France; CRNHO, West Human Nutrition Research Center, CHU, Nantes, France.; L'institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France; L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France.; L'institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France. Electronic address: [email protected].

DOI: 10.1016/j.jacl.2018.09.010

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MeSH Terms: Aged, Aged, 80 and over, Bile, Cholangiocarcinoma, Cholestasis, Cholesterol, Feces, Female, Hepatobiliary Elimination, Humans, Intestinal Elimination, Intestines, Male, Plasma, Prospective Studies