Bile contains four
calcium anions which are readily precipitated by
calcium: bilirubinate, "
palmitate",
carbonate and
phosphate. Precipitation of insoluble
calcium salts is common in calculous biliary disease. All animal models of
calcium cholelithiasis probably share a common pathogenesis--an increased concentration of a
calcium-sensitive
anion. In
calcium bilirubinate cholelithiasis, an increased concentration of bilirubinate occurs. In mice, this occurs in animals having a genetic
hemolytic anemia; in rats, it may be induced by an essential
fatty acid in combination with
diet modification; in dogs, by a low-
taurine,
low-protein diet; and in prairie dogs, by ileal resection which probably increases the bilirubinate/
bile acid ratio in bile. In the two models of
calcium-
bile acid cholelithiasis, an increased biliary concentration of a
calcium-sensitive
glycine conjugated
bile acid is induced by administration of a suitable precursor. In the rabbit,
gallstones composed mostly of
calcium allodeoxycholyl
glycine are induced by the feeding of
5 beta-cholestan-3 beta-ol. In the
taurine-deficient rat, the feeding of
lithocholate leads to formation of
gallstones which contain a mixture of
calcium lithocholyl
glycine and 3 alpha, 6 beta-dihydroxy cholanoyl
glycine. These animal models may be of value in testing agents designed to lower
calcium activity in bile.