The Expression Levels of Plasma Membrane Transporters in the Cholestatic Liver of Patients Undergoing Biliary Drainage and Their Association With the Impairment of Biliary Secretory Function

Shoda, Junichi; Kano, Masahito; Oda, Koji; Kamiya, Junichi; Nimura, Yuji; Suzuki, Hiroshi; Sugiyama, Yuichi; Miyazaki, Hiroshi; Todoroki, Takeski; Stengelin, Siegfried; Kramer, Werner; Matsuzaki, Yasushi; Tanaka, Naomi
December 2001
American Journal of Gastroenterology;Dec2001, Vol. 96 Issue 12, p3368
Academic Journal
OBJECTIVES: Percutaneous transhepatic biliary drainage (PTBD) has been believed to reduce hyperbilirubinemia in patients with obstructive cholestasis and to lessen liver injury through bile acid retention. The efficacy may be closely related to the capability of cholestatic liver to produce and secrete bile, which in turn depends on the expressions and functional activities of plasma membrane transporters in the liver. The aim of the present study was to determine the expression levels of these transporters in the cholestatic liver of patients undergoing PTBD. METHODS: A total of 24 patients who had experienced obstructive cholestasis and had undergone preoperative PTBD were included in the study. Liver biopsy specimens were analyzed to determine the expression levels of the multidrug resistance-associated proteins (MRP) MRP2 and MRP3 and the canalicular bile salt export pump BSEP in the liver RESULTS: The messenger RNA (mRNA) levels of MRP2 the canalicular bilirubin conjugate export pump, and bile salt export pump (BSEP) were unchanged in liver specimens from the 14 patients well drained by PTBD but were reduced in specimens from the 10 patients poorly drained, compared to the levels of control subjects. Immunostainings of MRP2 and BSEP outlined the canalicular membrane domain but seemed fuzzy to varying degrees in specimens obtained from cholestatic liver, especially in specimens from liver that had been poorly drained, in contrast to the linear and intense localization in the liver of control subjects, correlating with the impaired bilirubin conjugate and bile acid secretion. The mRNA of MRP3, functioning as an inducible export pump for bilirubin conjugate and bile acid. was expressed not only in the cholestatic liver but also in the liver of control subjects, and the mRNA level was increased in specimens from both the cholestatic liver that had been well drained and from the liver that had been poorly drained....


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