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Nucleation and Aggregation of Cholesterol Crystals in the Early Phase of Gallstone Genesis

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Gallstone Disease

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Abstract

Lipid composition does not seem to be a good criteria for discriminating between the bile of healthy subjects and that of patients with cholesterol gallstones (Table 1). About 30%–70% of healthy persons have bile supersaturated in cholesterol [37] and transported in varying proportions as mixed micelles (completely saturated only with cholesterol or 50% saturated with lecithin) and vesicles [60] having a larger size and greater ratio of cholesterol to phospholipids (Ch/PL ratio) than micelles [77]. Mixed micelles are frequently metastable, i.e., in a state of incomplete and unstable crystallinity which can drop to a lower free-energy level over time with the formation of different phases [76]. Vesicles have a greater cholesterol-solubilizing capacity (Ch/PL molar ratio approximately 1) than mixed micelles and can remain stable for a long time [18]. Therefore bile, like other biological systems, is thermodynamically unstable until its free energy reaches the minimum [29].

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  1. Patologia Speciale Medica, Università di Modena, Viale Vittorio Veneto 9, 41100, Modena, Italy

    G. Salvioli, R. Lugli & M. Pellati

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  1. Abteilung Innere Medizin II, Gastroenterologie und Ernährungswissenschaften, Universitätsklinikum Ulm, Robert-Koch-Straße 8, D-7900, Ulm, Germany

    W. Swobodnik  & H. Ditschuneit  & 

  2. Division of Gastroenterology, University of Texas Medical Branch at Galveston, 4.106 McCullough, G-64, 77550, Galveston, TX, USA

    R. D. Soloway

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Salvioli, G., Lugli, R., Pellati, M. (1990). Nucleation and Aggregation of Cholesterol Crystals in the Early Phase of Gallstone Genesis. In: Swobodnik, W., Soloway, R.D., Ditschuneit, H. (eds) Gallstone Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-74619-2_2

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