1. Chylomicron remnants, the intermediate intestinal lipoproteins carrying the bulk of dietary cholesterol, are actively taken up and degraded in the hepatocytes, releasing cholesterol which can be excreted in bile. To study this pathway, a mass of remnants, leading to a consistent rise in hepatic cholesterol, was administered as an intravenous bolus in rats with chronic bile fistula equilibrated by water, electrolyte and taurocholate infusions, and changes in biliary lipids and bile acids were evaluated for up to 24 h in comparison with baseline.
2. A mean 16% increase in the net output of bile acids was observed at each time interval after lipoprotein injection, accounting for a 24 h cumulative excretion of approximately one-third of the administered cholesterol mass. These changes did not reach statistical significance however. The cholesterol output and concentrations of all biliary lipids did not vary either. Without taurocholate replacement, remnants injection was followed by a 15–20% decrease in bile acid and bile lipid secretion, presumably due to an insufficient hepatic bile-acid flux.
3. When [3H]cholesterol-labelled remnants were administered at the same mass in the chronic equilibrated bile fistula model, 21% of injected radioactivity was excreted in 24 h, distributing mostly in acidic rather than neutral sterols (20.02 ± 1.85 compared with 1.07 ± 0.04), with an acidic to neutral sterol mean ratio of 16.
4. To exclude interfering effects from the administered cholesterol mass and chronic bile fistula, 3H-labelled remnants were also studied as a cholesterol trace injected in rats with acute bile fistula. In this case, however, 24 h total sterol radioactivity only reached approximately 10% of that injected, and partitioned relatively less in acidic (6.84 ± 0.59) than in neutral (3.15 ± 0.39) sterols, with an acidic to neutral sterol mean ratio of 2.
5. The study suggests that remnant cholesterol reaches bile mainly in the form of bile acids, by a steady slow-rate process which is magnified under conditions of stimulated bile-acid synthesis.
Speed of change in biliary lipids and bile acids with chenodeoxycholic acid--is intermittent therapy feasible?