Endogenous elevation of plasma cholecystokinin does not prevent gallstones

Eur J Clin Invest. 2015 Mar;45(3):237-46. doi: 10.1111/eci.12400.

Abstract

Background: Regular gall bladder contraction reduces bile stasis and prevents gallstone formation. Intraduodenal administration of exogenous pancreatic secretory trypsin inhibitor-I (PSTI-I, also known as monitor peptide) causes cholecystokinin (CCK) secretion.

Design: We proposed that stimulation of CCK release by PSTI would produce gall bladder contraction and prevent gallstones in mice fed a lithogenic diet. Therefore, we tested the effect of overexpression of rat PSTI-I in pancreatic acinar cells on plasma CCK levels and gall bladder function in a transgenic mouse line (TgN[Psti1]; known hereafter as PSTI-I tg).

Results: Importantly, PSTI tg mice had elevated fasting and fed plasma CCK levels compared to wild-type (WT) mice. Only mice fed the lithogenic diet developed gallstones. Both fasting and stimulated plasma CCK levels were substantially reduced in both WT and PSTI-I tg mice on the lithogenic diet. Moreover, despite higher CCK levels PSTI-I tg animals developed more gallstones than WT animals.

Conclusions: Together with the previously observed decrease in CCK-stimulated gall bladder emptying in mice fed a lithogenic diet, our findings suggest that a lithogenic diet causes gallstone formation by impaired CCK secretion in addition to reduced gall bladder sensitivity to CCK.

Keywords: Bile salts; cholesterol crystals; gall bladder motility; intestinal hormone; lithogenic bile; mucin gel.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acinar Cells / metabolism
  • Animals
  • Cholecystitis / pathology
  • Cholecystokinin / metabolism*
  • Diet
  • Gallbladder / pathology
  • Gallbladder Emptying / physiology
  • Gallstones / physiopathology
  • Gallstones / prevention & control*
  • Intercellular Signaling Peptides and Proteins / genetics
  • Intercellular Signaling Peptides and Proteins / metabolism*
  • Lipid Metabolism / physiology
  • Male
  • Mice, Inbred C57BL
  • Organ Size / physiology
  • Pancreas / cytology
  • Rats
  • Trypsin Inhibitor, Kazal Pancreatic

Substances

  • Intercellular Signaling Peptides and Proteins
  • Spink1 protein, rat
  • Trypsin Inhibitor, Kazal Pancreatic
  • Cholecystokinin