Taiju Kuramoto

Cerebrotendinous xanthomatosis: Clinical and biochemical evaluation of eight patients and review of the literature

We present the clinical and laboratory findings of 8 patients with cerebrotendinous xanthomatosis. The clinical features consisted of a combination of bilateral Achilles tendon xanthomas, cataracts, low intelligence, pyramidal signs, cerebellar signs, convulsions, peripheral neuropathy, foot deformity, cardiovascular disease or atherosclerosis, EEG abnormality, and increased CSF protein. Increased cholesterol was present in the serum, CSF and red cell membrane of all 8 patients. The bile of one patient with late age onset of the disease showed an attenuated production of bile acids and bile alcohols. Three of the 7 had obstruction and/or marked narrowing of the coronary arteries. Data on 136 patients reported throughout the world are reviewed.

Effect of dietary taurine on bile acid metabolism in guinea pigs.

The effect of oral administration of taurine (200–300 mg daily) on the metabolism of bile acids was studied in male guinea pigs which have predominantly glycine conjugated bile acids. The results were summarized as follows: (a) oral administration of taurine for 10 days increased taurine-conjugated bile acids and the ratio of glycine-to taurine-conjugated bile acids (G:T ratio) shifted from 3.95 to 0.19; (b) in taurine fed guinea pigs, the half-life of chenodeoxycholic acid (CDC) was about 40% shorter than that in controls and the fractional turnover rate increased by 70%; (c) the synthetic rate (mg/day/500 g body weight) of bile acids increased from 4.28 to 7.27 by taurine feeding; (d) hepatic cholesterol 7α-hydroxylase activity was increased 2.4-fold by taurine feeding; (e) the total pool size of bile acids did not change significantly but the amount of lithocholic acid in the caecum and large intestine increased by about 40%; (f) neither free cholesterol nor cholesterol ester levels in liver and serum changed significantly. Results of this study suggest that changing the G:T ratio in the bile acid conjugation pattern may influence the rate of hepatic bile acid synthesis.

Synthesis, intestinal absorption and metabolism of sarcosine conjugated ursodeoxycholic acid

Sarcosine conjugated ursodeoxycholic acid (SUDC) was synthesized and its intestinal absorption and metabolism were studied in rat and hamster. Intestinal absorption study using bile fistula rat shows that more than 90% of SUDC administered intraduodenally was excreted in the bile within 24 hr. No change of the administered bile acid was seen during the absorption from the intestine, the passage of the liver, and the excretion into the bile. When [24-14C]SUDC and [11,12-3H2]-ursodeoxycholic acid were administered orally to a hamster, more than 95% of both the administered 14C and 3H were recovered from the feces within 6 days. Most (77%) of the fecal 14C-labeled compound was SUDC, whereas 95% of the fecal 3H-labeled compound was unconjugated lithocholic acid. These results indicate that SUDC, unlike taurine or glycine conjugated bile acid, resists bacterial deconjugation and 7-dehydroxylation.

Identification of (23S)-5β-cholestane-3α,7α,12α,23,25-pentol in cerebrotendinous xanthomatosis1,2

The synthesis of (23R)- and (23S)-5β-cholestane-3α,7α, 12α,23,25-pentols is described. Norcholyl aldehyde was converted into the cholestanepentols by a Reformatsky reaction with ethyl bromoacetate followed by a Grignard reaction with methylmagnesium iodide. One of the synthetic pentols, the 23S epimer was identical with a bile alcohol isolated from patients with cerebrotendinous xanthomatosis.

A rapid and sensitive method for the determination of the lithogenic index of bile by thin-layer chromatography and densitometry using a dual-wavelength chromatoscanner.

Abstract A rapid and sensitive method for quantitative determination of three bile lipid components, cholesterol, bile acids, and lecithin, is described. These components were separated by thin-layer chromatography on a silica gel plate, spots were visualized with a phosphomolybdate reagent, and their color intensities were estimated by direct densitometry using a dualwavelength chromatoscanner. The lithogenic index was estimated by the molar ratio of the three lipids. This method can be applied to the routine analysis of bile in patients with gallstones. It has been evaluated by comparison with the method using standard gas-liquid chromatography and spectrophotometry.

Identification of bile alcohols in normal rabbit bile

Rabbit bile was examined for bile alcohols. Using combined gas chromatography-mass spectrometry, 5 beta-cholestane-3 alpha, 7 alpha, 12 alpha, 25,26-pentol, 5 beta-cholestane-3 alpha, 7 alpha, 12 alpha, 25--tetrol, 5 beta-cholestane-3 alpha, 7 alpha, 12 alpha,24 beta-tetrol, 24-methyl-25-homo-5 beta-cholane-3 alpha, 7 alpha, 12 alpha, 24-tetrol, and 5 alpha-cholestane-3 alpha, 7 alpha, 12 alpha, 24 beta-tetrol were identified as the minor constituents of normal rabbit bile.

Urinary bile alcohol profiles in healthy and cholestatic children.

BACKGROUND Bile alcohols are normal constituents of urine. METHODS To better understand bile alcohol profile in childhood, urinary specimens from 41 healthy children and 10 children with cholestasis, and 3 healthy adults, were analyzed by GLC and GC-MS. RESULTS Five bile alcohols, 27-nor-5beta-cholestane-3alpha,7alpha,12alpha,24S,25R-pentol, 5beta-cholestane-3alpha,7alpha,12alpha,24S, 25-pentol, 5beta-cholestane-3alpha,7alpha,12alpha,24S,26-pentol, 5beta-cholestane-3alpha,7alpha, 12alpha,25,26-pentol, and 5beta-cholestane-3alpha,7alpha,12alpha,26,27-pentol were identified in all specimens. C(26)-Pentol was the most abundant constituent, constituting 29.5 to 65% of bile alcohols. Among healthy children (n=41), no significant relationship was seen between proportions of the C(26)-pentol and age, but older children (n=15, 6 to 14 years) showed a significantly greater mean percentage of the C(26)-pentol than young children (n=26, 0 to 5 years; 58.1+/-4.23% vs. 46.0+/-9.24%, p<0.001). In children with cholestatic liver diseases, the percentage of C(26)-pentol in urinary bile alcohols was significantly lower than age-matched controls. CONCLUSIONS There is an increased composition of C(26)-pentol in older children and relatively decreased composition of C(26)-pentol in children with cholestatic liver diseases.

Urinary bile alcohol profile in infants with intrahepatic cholestasis: identification of 5β-cholestane-3α,7α,24,25-tetrol

Urinary bile acids and bile alcohols were examined in six infants aged between 1 and 6 mo who had intrahepatic cholestasis. Following extraction, hydrolysis and solvolysis, cholanoids were analysed by gas‐liquid chromatography and gas‐liquid chromatography‐mass spectrometry. The relative ratio of the urinary excretion of bile alcohols to bile acids was very low (0.07‐0.22) in three patients with mild to severe cholestasis, whereas the urinary excretion of bile alcohols was 2–4 times greater than that of the total bile acids in three patients with slight cholestasis. The urinary bile alcohol spectrum in infants appears to be quite different from that in adults. Although the major bile alcohol was 27‐nor‐5β‐cholestane‐3α,7α,12α,24,25‐pentol, comprising more than 50% of total urinary bile alcohols in healthy adults, it accounted for only 35% of total urinary bile alcohols in our patients. In addition, bile alcohols carrying chenodeoxycholic acid type nucleus were detected in our patients by comparison of the retention times and mass spectra with those of authentic standards. The presence of 5β‐cholestane‐3α,7α,24,25‐tetrol confirmed for the first time in this study may represent an alternative pathway for chenodeoxycholic acid biosynthesis via a “25‐hydroxylation pathway” in early life.

Comparative studies on ω-hydroxylation of 5β-cholestane-3α, 7α,12α-triol in the mitochondrial and microsomal fraction of the liver from several vertebrates

Abstract The activity and the stereospecificity of ω-hydroxylation, a hydroxylation at one of the two terminal methyl groups of 5β-cholestane-3α,7α, 12α-triol, which is thought to be the first step in side-chain degradation resulting in the formation of cholic acid, was elucidated in mitochondria and microsomes of the liver from several evolutionarily primitive vertebrates, fish, frogs, turtles, and chickens in addition to such mammals as rats, hamsters, and rabbits. The detection of ω-hydroxylation products (25R)- and (25S)-5β-cholestane-3α, 7α, 12α, 26-tetrols as well as the separation of their two isomers was facilitated using high-performance liquid chromatography after conversion to 9-anthroyl derivatives. All the mammals examined, except for the rat, exhibited predominant activity in the mitochondrial fraction. Although the hydroxylation activity was somewhat lower in the primitive vertebrates, it was present in the mitochondria more than in the microsomes. Furthermore, the stereospecific formation of a 25R-isomer was detected in the mitochondrial fraction of most animals estimated. However, activity in the carp liver was seven times higher in the microsomes than in the mitochondria, and the hydroxylation product was almost always a 25R-isomer. ω-Hydroxylation activity could not be detected in rainbow trout, suggesting the existence of another biosynthetic pathway, not via 26-hydroxylation, as in the 25-hydroxylation pathway, for the production of bile acid.

Bile acid sulfonate and 7-alkylated bile acid analogs : effect on intestinal absorption of taurocholate and cholesterol 7α-hydroxylase activity in cultured rat hepatocytes

The effects of sulfonate analogs of cholic (C), chenodeoxycholic (CDC), and ursodeoxycholic acid (UDC) and three 7-alkylated CDCs--7-methyl-, 7-ethyl-, and 7-propyl-CDCs--on taurocholate absorption from rat terminal ileum in situ and on cholesterol 7alpha-hydroxylase activity in primary culture of the rat liver were investigated. The sulfonate analogs of two dihydroxy bile acids CDC and UDC, but not C, significantly decreased the absorption of taurocholate. Taurine conjugates of 7-alkylated CDC slightly decreased the taurocholate absorption, and tauro-7-propyl-CDC significantly suppressed the absorption. Although the sulfonate analogs of C and CDC reduced cholesterol 7alpha-hydroxylase activity by 40% and 60% compared to control, UDC-sulfonate analog did not affect enzymatic activity. These results were consistent with those of the lead compounds, C, CDC, and UDC. The introduction of methyl group at C-7 position of CDC attenuated the reduction in cholesterol 7alpha-hydroxylase activity by CDC. However, elongation of the alkyl group resulted in an inhibitory effect. The present study revealed the following: 1) bile acid sulfonates act on cholesterol and bile acid metabolism in a similar manner as taurine conjugated bile acids; and 2) the biologic properties of CDC could be altered by the introduction of alkyl group at C-7 position.