Acidic and Basic Solutions Dissolve Protein Plugs Made of Lithostathine Complicating Choledochal Cyst/Pancreaticobiliary Maljunction |
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Authors: | Kenitiro Kaneko Yasuyuki Ono Takahisa Tainaka Wataru Sumida Hisami Ando |
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Institution: | (1) Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan |
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Abstract: | Background Symptoms of choledochal cysts are caused by protein plugs made of lithostathine, which block the long common channel and
increase pancreaticobiliary ductal pressure. Agents that dissolve protein plugs can provide relief from or prevent symptoms.
In the present study, drugs reportedly effective for pancreatic and biliary stones were used in dissolution tests. Methods Protein plugs were obtained from choledochal cysts during surgery in two children (5- and 6-year-old girls). Plugs approximately
2 mm in diameter were immersed in citric acid, tartaric acid, dimethadione, bromhexine, dehydrocholic acid, sodium citrate,
hydrochloric acid, and sodium hydroxide solutions under observation with a digital microscope. The pH of each solution was
measured using a pH meter. Results Plugs dissolved in citric acid (5.2 mM; pH 2.64), tartaric acid (6.7 mM; pH 2.51), dimethadione (75 mM; pH 3.70), hydrochloric
acid (0.5 mM; pH 3.13), and sodium hydroxide (75 mM; pH 12.75) solutions. Plugs did not dissolve in dimethadione (7.5 mM;
pH 4.31), bromhexine (0.1%; pH 4.68), dehydrocholic acid (5%; pH 7.45), and sodium citrate (75 mM; pH 7.23) solutions. Conclusion Protein plugs in choledochal cysts are dissolved in acidic and basic solutions, which may eliminate longitudinal electrostatic
interactions of the lithostathine protofibrils. |
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Keywords: | Choledochal cyst Protein plugs Lithostathine Dissolution |
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