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Journal of Lipid Research, Vol. 43, 604-610, April 2002
Copyright © 2002 by Lipid Research, Inc.

Quantitation of cholesterol crystallization from supersaturated model bile

Piero Portincasaa,b, Niels G. Vennemana, Antonio Moschettaa,b, André van den Bergc, Giuseppe Palascianob, Gerard P. vanBerge-Henegouwena, and Karel J. van Erpecuma
a Department of Gastroenterology, University Medical Center Utrecht, The Netherlands
b Semeiotica Medica and Section of Internal Medicine, Department of Internal Medicine and Public Medicine, University Medical School, Bari, Italy
c Department of Gastrointestinal and Liver Diseases, Academic Medical Center Amsterdam, The Netherlands

Correspondence to: Karel J. van Erpecum, at the Department of Gastroenterology F.02.618, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands., k.j.vanerpecum{at}azu.nl (E-mail)

Cholesterol crystallization is an essential step in gallstone formation. Although spectrophotometry and nephelometry have been used for quantitation of crystallization, potential effects of crystal size and shape have not been evaluated. We determined crystallization in model biles [total lipid concentration 7.3 g/dl, egg yolk Phosphatidylcholine (EYPC)/(EYPC+taurocholate) molar ratio = 0.05, 0.15, or 0.30; cholesterol saturation index (CSI) = 1.2, 1.7, or 2.0; 37°C] plotting in the central three-phase (micelles, vesicles, and crystals containing) zone or in the left two-phase (micelles and crystals containing) zone of the equilibrium ternary phase diagram. Extent of crystallization estimated by spectrophotometry and nephelometry was related to chemical determination of crystal mass and to crystal size or shape (by microscopy). With all methods, crystallization was less extensive when vesicles were present (central three-phase zone) and at lower CSIs. In the left two-phase zone, particularly at EYPC/(EYPC+taurocholate), ratio of 0.15, there were strong increases in spectrophotometric and nephelometric readings during the first days of incubation, but decreases at later stages, despite progressive increases in crystal mass by chemical measurement. Initially, there were large numbers of very small crystals (<10 µm) in these biles, which were subsequently replaced by large cholesterol monohydrate crystals. Decreasing sizes of harvested cholesterol monohydrate crystals by sonication increased spectrophotometric and nephelometric values despite identical crystal mass.

When cholesterol crystal mass is assayed by indirect methods such as spectrophotometry or nephelometry, results are strongly influenced by crystal size.—Portincasa, P., N. G. Venneman, A. Moschetta, A. van den Berg, G. Palasciano, G. P. vanBerge-Henegouwen, and K. J. van Erpecum. Quantitation of cholesterol crystallization from supersaturated model bile. J. Lipid Res. 2002. 43: 604–610.

Supplementary key words: bile salts, gallstone, micelles, microscopy, nephelometry, phosphatidylcholine, phospholipids, spectrophotometry, taurocholate, vesicles


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