Lipid Deposits and Lipo-mucosomes in Human Cholecystitis and Epithelial Metaplasia in Chronic Cholecystitis

Gilloteaux, Jacques; Tomasello, Lisa M.; Elgison, Deborah A.

doi:10.1080/716100787

Cited by 6 publications

(7 citation statements)

References 27 publications

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“…With chronic cholelithiasis, fatty degeneration of scattered epithelial cells appears to alter the epithelial lining and favors metaplastic change that could lead to other pathologic changes, including carcinoma in situ-like lesions. In addition to lipid deposition in macrophages, lipid is also incorporated in other cells and tissues of the gallbladder wall including endothelium of capillaries, smooth muscles, and fibrocytes [62]. Increased gallbladder wall fat and its associated abnormalities were also shown in other studies in patients with calculous and acalculous cholecystitis [56,[63][64][65].…”

Section: Gallbladder Fat and Steatocholecystitismentioning

confidence: 94%

“…A recent study on human gallbladder lipids using electron microscopy demonstrated that there is an increased accumulation of fat in gallbladder smooth muscle fibers in patients with cholecystitis [62]. Among the inflammatory changes seen in cholecystitis, the ultrastructural alterations of the human gallbladder epithelium include lipid and lipofuscin deposits, fusions of lipid deposits and mucuscontaining vesicles forming lipo-mucosomes.…”

Section: Gallbladder Fat and Steatocholecystitismentioning

confidence: 97%

“…Similarly, in the gallbladder, this phenomenon of enhanced inflammation causes steatocholecystitis [63], resulting in an abnormal wall structure with an increased amount of fat and decreased contractility. TNF-a is known to play an important role in initiating inflammation by stimulating expression of other inflammatory mediators, including leptin and IL-6, which affects the absorption, secretion, and smooth muscle contractility of gallbladder [51,57,62,69]. Impaired gallbladder absorption and gallbladder emptying may be early events in gallstone formation [70,71].…”

Section: Gallbladder Fat and Steatocholecystitismentioning

confidence: 98%

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Steatocholecystitis and Fatty Gallbladder Disease

Tsai

2008

Dig Dis Sci

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Obesity has become an epidemic worldwide. It is accompanied by a multitude of medical complications including metabolic syndrome. Obesity may lead to fatty infiltration of multiple internal organs including liver, heart, kidney, and pancreas, causing organ dysfunctions. Fatty infiltration leads to chronic inflammation and tissue damage. Fatty infiltration in the liver results in nonalcoholic fatty liver disease, which is increasingly common nowadays. Recent studies in animals and humans indicate that obesity also is associated with fatty infiltration of gallbladder, resulting in cholecystosteatosis. The increased gallbladder lipids include free fatty acids, phospholipids, and triglycerides. Enhanced inflammation with an increased amount of fat in the gallbladder results in an abnormal wall structure and decreased contractility. In support of this notion, a recent experiment on the effect of Ezetimibe, which is a novel drug that inhibits intestinal fat absorption, on fatty gallbladder disease reveals that Ezetimibe can ameliorate cholecystosteatosis and restore in vivo gallbladder contractility. The proportion of cholecystectomies performed for chronic acalculous cholecystitis has increased significantly over the past two decades. An increase in gallbladder fat, which leads to poor gallbladder emptying and biliary symptoms, may partly explain this phenomenon. Although dietary carbohydrates have been demonstrated to be associated with fatty gallbladder disease, other potential modifiable environmental factors are not clear. The pathogenesis and prognosis of fatty gallbladder disease, including steatocholecystitis, and the relations of fatty gallbladder disease to nonalcoholic fatty liver disease, including steatohepatitis, and other components of metabolic syndrome are largely unknown. More research is needed to answer these questions.

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Section: Gallbladder Fat and Steatocholecystitismentioning

confidence: 94%

Section: Gallbladder Fat and Steatocholecystitismentioning

confidence: 97%

Section: Gallbladder Fat and Steatocholecystitismentioning

confidence: 98%

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Steatocholecystitis and Fatty Gallbladder Disease

Tsai

2008

Dig Dis Sci

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“…44,45 In the gallbladder, TNF-a leads to an inflammatory response, which has been shown to alter gallbladder absorption and secretion. 46 Electron microscopy studies by Gilloteaux et al 47,48 of gallbladders from patients with cholesterol gallstones also have demonstrated lipid mucosomes in the mucosa. These authors have postulated that mucosal lipids affect absorption and/or secretion.…”

Section: Discussionmentioning

confidence: 94%

Cholecystosteatosis: an Explanation for Increased Cholecystectomy Rates

Al-Azzawi

Nakeeb

Saxena

et al. 2007

Journal of Gastrointestinal Surgery

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These data suggest that compared to nondiseased controls, (1) patients with acalculous cholecystitis are younger and have increased gallbladder fat and (2) patients with calculous cholecystitis have increased gallbladder fat and inflammation. We conclude that increased gallbladder fat may lead to poor gallbladder emptying and biliary symptoms. Thus, cholecystosteatosis may explain, in part, the increased need for cholecystectomy and the higher percentage of these patients with acalculous cholecystitis.

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“…In addition, we have demonstrated that patients with acalculous and calculous cholecystitis have increased gallbladder wall fat [4]. Gilloteaux et al, using electronmicroscopy, also demonstrated that patients with cholecystitis have an increased accumulation of fat in individual gallbladder smooth muscle fibers [5]. In obesity, adipose tissue produces adipokines, which increase local macrophages and proinflammatory cytokines resulting in organ dysfunction [2,6,7].…”

Section: Introductionmentioning

confidence: 96%