The formation of abnormal bile and cholesterol gallstones from dietary cholesterol in the prairie dog

To study the pathogenesis of cholesterol gallstones, we fed 24 adult male prairie dogs a high cholesterol, egg yolk diet. 13 control animals received a cholesterol-free diet. All animals fed the egg yolk diet formed multiple gallstones in 2-6 months' time. These stones contained cholesterol, 77+/-14% by dry weight. No stones ocurred in the control group. The egg yolk-fed animals developed bile of altered chemical composition. The cholesterol concentration of hepatic and gallbladder bile increased significantly. The molar ratios of bile acid/cholesterol and phospholipid/cholesterol decreased in hepatic and gallbladder bile. The predominant bile acid shifted from cholic acid, 78% of the total bile acids, to chenodeoxycholic acid, 60% of the total. In common bile duct cannulated animals the high cholesterol diet produced increased secretion of cholesterol by the liver and increased bile flow. In animals fed the egg yolk diet for 2 months, cholesterol-4-(14)C was included in the daily diet for the next 4 months to establish an isotopic steady state. At autopsy the mean specific activity of cholesterol was similar in serum, liver, hepatic bile, gallbladder bile, and gallstones. Thus the cholesterol of gallstones apparently equilibrated constantly throughout the study and was not sequestrated as a static pool. The high cholesterol, egg yolk diet caused the secretion of an "abnormal bile" which led to precipitation of cholesterol from micellar solution. The increased bile cholesterol relative to bile acid and phospholipid favored stone formation. This dietary induction of cholesterol gallstones provided a unique animal model, in part but not completely analogous to human cholelithiasis.