A study of the excretion of bromsulphthalein in the bile

Biliary Transport and Hepatic Storage of Sulfo-Bromophthalein Sodium in the Unanesthetized Dog, in Normal Man, and in Patients With Hepatic Disease *

“…Hepatocellular accumulation or "storage" of BSP was first suggested by the demonstration of a marked delay between removal from the blood and excretion into the bile after the dye was administered intravenously to dogs (2,3), and a similar mechanism in man was inferred from a study of the hepatic removal of successive doses of BSP (4). The accumulation of a related phthalein dye, fluorescein, in hepatic polygonal cells has actually been visualized in living frog and rat livers by the technique of fluorescence microscopy (5,6).…”

“…The high concentrations of BSP observed in the bile (2) indicate that the ultimate excretion of this dye undoubtedly depends upon an active transport mechanism. There is convincing indirect evidence in the dog (9)(10)(11), in the rabbit (12,13), and in man (14,15) that the secretion of BSP into the bile is limited by a definite maximal rate, analogous to the transport maximum, or "Tm," which is demonstrable for many substances secreted by the renal tubules.…”

The Biliary Excretion of Bromsulfalein as a Test of Liver Function in a Group of Patients Following Hepatitis or Serum Jaundice

“…The method of testing liver function by the biliary excretion of bromsulfalein has been described in detail previously and when further reference is made to it in this paper it will be called the biliary bromsulfalein test (22,23,27 (2) delayed appearance of the dye in the bile; (3) delayed attainment of the maximum concentration; (4) prolonged high curve (plateau-type) of excretion; (5) subnormal concentration (flat type of curve); (6) abnormally low total excretion in one-or two-hour periods after injection (28).…”

“…The blood clearance of bromsulfalein is generally considered a highly useful chemical test when liver impairment is minimal (21). However, we have experimental evidence tn dogs which suggests that the clearance of bromsulfalein from the blood is probably dependent upon a dual mechanism; first, removal from the blood by the reticulo-endothelial system (Kupfer cells) and second, excretion by the hepatic polygonal cells into the bile and that early hepatic damage can cause severe impairment of the excretion of bromsulfalein in the bile without interfering with its removal from the blood (22)(23)(24). The cephalin flocculation and thymol turbidity tests are not specific tests of liver function because they have been shown to yield positive results in other diseases.…”

Studies on bromsulphalein and cardiac output in the hepatectomized dog

“…Mendeloff et al (1949) have noted conflicting evidence regarding the reticulo-endothelial system and by inference stated that BSP is removed by hepatic polygonal cells. Bromsulphalein has been recovered in the bile in 27-100 % of the amount injected (Wirts & Cantarow, 1942). Using 35S tagged BSP nearly quantitative recovery of 35S infused was obtained from liver, blood and bile (Brauer, Krebs & Pessotti, 1950).…”