WordNet

a digestive juice secreted by the liver and stored in the gallbladder; aids in the digestion of fats (同)gall
irritate or vex; "It galls me that we lost the suit" (同)irk
a skin sore caused by chafing
abnormal swelling of plant tissue caused by insects or microorganisms or injury
suffering from or suggesting a liver disorder or gastric distress (同)liverish, livery
relating to or containing bile (同)biliary
relating to the bile ducts or the gallbladder
a special anniversary (or the celebration of it)
a device on an automobile for making a warning noise (同)car horn, motor horn, horn, hooter
a race between (usually high-performance) automobiles (同)auto race, car race
an anniversary celebrating the passage of 25 years

PrepTutorEJDIC

胆汁(たんじゅう) / かんしゃく;不きげん
《古》(特に牛の)胆汁(たんじゅう) / (経験などの)苦さ,苦々しい思い《+『of』+『名』》 / 《英話》(…する)厚かましさ,ずうずうしさ《+『to』 do》
(皮膚の)すり傷;(特に馬具による馬の)くらずれ / …‘の'皮膚(皮)をすりむく / 〈人〉‘を'いらだたせる / すれてひりひりする,すりむける
虫こぶ(昆虫の働きによって樹木,特にカシの木の葉などにできる)
胆汁(たんじゅう)の,胆汁質の / 気むずかしい,かんしゃく持ちの
(特に25年または50年の)記念祭 / (一般に)祝祭,祝賀の時期

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/12/01 12:24:57」(JST)

wiki ja

[Wiki ja表示]

肝臓から分泌された胆汁は一時的に胆嚢で濃縮される。食事によりCCKホルモン等が放出されると総胆管を通じて胆汁は十二指腸中に分泌される。
胆管周辺の模式図

en:Liver:肝臓、RHD(Right hepatic duct): 右肝管、LHD(Left hepatic duct):左肝管、CHD(en:Common hepatic duct):総肝管、en:Cystic duct:胆嚢管、en:Common bile duct:総胆管、en:Gall Bladder:胆嚢、en:Sphincter of Oddi:オッディ括約筋、en:Ampulla of Vater:ファーター膨大部、en:Pancreatic duct:膵管、en:Pancreas:膵臓、en:Duodenum:十二指腸

胆汁（たんじゅう）は、肝臓で生成される黄褐色でアルカリ性の液体である。肝細胞で絶えず生成され、総肝管を通って胆のうに一時貯蔵・濃縮される。食事時に胆のうが収縮され、総胆管の十二指腸開口部であるオッディ括約筋が弛緩し十二指腸に排出されて働く。胆汁は3つに分類される。

A胆汁（胆管胆汁） - ファーター乳頭から分泌する
B胆汁（胆のう胆汁） - 胆嚢で濃縮
C胆汁（肝胆汁） - 肝細胞で産生

胆汁の働き

胆汁は1日に約600ml分泌される。胆汁酸と胆汁色素を含み、前者は界面活性剤として食物中の脂肪を乳化して細かい粒とし、リパーゼと反応しやすくすることで脂肪の消化吸収に重要な役割を果たすが、消化酵素は含まれない。

胆汁酸: 脂肪を乳化して消化酵素の働きを助ける。更に脂肪の分解産物に作用して小腸から吸収されやすく変化させる。また腸内に分泌された胆汁酸の殆どは小腸で再吸収され、肝臓に戻される（腸肝循環）。
胆汁色素: 破壊された赤血球から遊離したヘモグロビンのタンパク質部分から切り離されたヘムが、肝臓の細胞で代謝され黄色のビリルビンに変化する。ビリルビンは肝臓でグルクロン酸抱合を受けて水溶性が高められて胆汁色素として胆汁とともに分泌される。ビリルビンの大半は腸内で腸内細菌によりウロビリノーゲンに還元され、その一部が体内に再度吸収される。ウロビリノーゲンは抗酸化作用を有し^[1]^[2]、これが体内で酸化を受けると黄色のウロビリンに変化する。通常の尿の黄色はウロビリンによるものである。これらの循環は腸肝ウロビリノーゲンサイクルと呼ばれている。一方、腸内に残ったウロビリノーゲンは腸内細菌によりステルコビリノーゲンに還元される。ステルコビリノーゲンが酸化を受けると茶色のステルコビリンに変化する。ステルコビリンは大便とともに排泄され、大便の茶色の元となる。

胆石

ヒトにおけるコレステロールの排泄は肝臓から胆汁として分泌されるが、その際にコレステロールの一部から肝臓で生合成される胆汁酸と複合体を形成して排泄される。

胆汁の中のコレステロールは胆汁酸により分散安定化されているが、胆のうで胆汁が濃縮される際に何らかの原因で遊離しコレステロールの結晶が成長すると、胆のうあるいは胆管においてコレステロール胆石症の原因となる場合もある。胆石の他の原因であるレシチンやビリルビンによる結石は稀である。

脚注

^ 中村宜司、佐藤克行、秋葉光雄「胆汁色素代謝物ウロビリノーゲンの抗酸化作用」中村宜司『日本農芸化学会誌』2001年3月5日、75巻、144ページ。胆汁 - J-GLOBAL
^ NAKAMURATakashi; SATOKatsuyuki; AKIBAMitsuo; OHNISHIMasao (2006). “Urobilinogen, as a Bile Pigment Metabolite, Has an Antioxidant Function”. Journal of Oleo Science (日本油化学会) 55 (4): 191-197. doi:10.5650/jos.55.191. NAID 130000055572.

この項目は、医学に関連した書きかけの項目です。この項目を加筆・訂正などしてくださる協力者を求めています（プロジェクト:医学／Portal:医学と医療）。

wiki en

[Wiki en表示]

Bile (yellow material) in a liver biopsy in the setting of bile stasis, i.e. cholestasis. H&E stain

Action of bile salts in digestion

Recycling of the bile

Bile or gall is a bitter-tasting, dark green to yellowish brown fluid, produced by the liver of most vertebrates, that aids the digestion of lipids in the small intestine. In humans, bile is produced continuously by the liver (liver bile), stored and concentrated in the gallbladder (gallbladder bile) and when the organism eats, is discharged into the duodenum. The composition of gallbladder bile is 97% water, 0.7%^[1] bile salts,^[2] 0.2% bilirubin, 0.51% fats (Cholesterol, fatty acids and lecithin),^[2]^[3] and 200 mEq/L inorganic salts.^[4]

Function

Bile acts to some extent as a surfactant, helping to emulsify the lipids in food. Bile salt anions are hydrophilic on one side and hydrophobic on the other side; consequently, they tend to aggregate around droplets of lipids (triglycerides and phospholipids) to form micelles, with the hydrophobic sides towards the fat and hydrophilic sides facing outwards. The hydrophilic sides are negatively charged, and this charge prevents fat droplets coated with bile from re-aggregating into larger fat particles. Ordinarily, the micelles in the duodenum have a diameter of around 14–33 μm.

The dispersion of food fat into micelles thus provides a greatly increased surface area for the action of the enzyme pancreatic lipase, which actually digests the triglycerides, and is able to reach the fatty core through gaps between the bile salts. A triglyceride is broken down into two fatty acids and a monoglyceride, which are absorbed by the villi on the intestine walls. After being transferred across the intestinal membrane, the fatty acids reform into triglycerides, before being absorbed into the lymphatic system through lacteals. Without bile salts, most of the lipids in food would be excreted in feces, undigested.

Since bile increases the absorption of fats, it is an important part of the absorption of the fat-soluble substances, such as the vitamins A, D, E and K.

Besides its digestive function, bile serves also as the route of excretion for bilirubin, a byproduct of red blood cells recycled by the liver. Bilirubin derives from hemoglobin by glucuronidation.

Bile is alkaline^{[citation needed]} and also has the function of neutralizing any excess stomach acid before it enters the duodenum, the first section of the small intestine. Bile salts also act as bactericides, destroying many of the microbes that may be present in the food.

Clinical significance

In the absence of bile, fats become indigestible and are instead excreted in feces, a condition called steatorrhea. Feces lack their characteristic brown color and instead are white or gray, and greasy.^[5] Steatorrhea can lead to deficiencies in essential fatty acids and fat-soluble vitamins. In addition, past the small intestine (which is normally responsible for absorbing fat from food) the gastrointestinal tract and gut flora are not adapted to processing fats, leading to problems in the large intestine.
The cholesterol contained in bile will occasionally accrete into lumps in the gallbladder, forming gallstones. Cholesterol gallstones are generally treated through surgical removal of the gallbladder. However, they can sometimes be dissolved by increasing the concentration of certain naturally occurring bile acids, such as chenodeoxycholic acid and ursodeoxycholic acid.
On an empty stomach – after repeated vomiting, for example – a person's vomit may be green or dark yellow, and very bitter. The bitter and greenish component may be bile or normal digestive juices originating in the stomach.^{[citation needed]} The color of bile is often likened to "fresh-cut grass",^{[citation needed]} unlike components in the stomach that look greenish yellow or dark yellow. Bile may be forced into the stomach secondary to a weakened valve (pylorus), the presence of certain drugs including alcohol, or powerful muscular contractions and duodenal spasms.

Society and culture

In medical theories prevalent in the West from Classical Antiquity to the Middle Ages, the body's health depended on the equilibrium of four "humors", or vital fluids: blood, phlegm, "yellow bile" (choler), and "black bile". These "humors" are believed to have its roots in the appearance of a blood sedimentation test made in open air, which exhibits a dark clot at the bottom ("black bile"), a layer of unclotted erythrocytes ("blood"), a layer of white blood cells ("phlegm") and a layer of clear yellow serum ("yellow bile"). Excesses of black bile and yellow bile were thought to produce aggression and depression, respectively; and the Greek names for them gave rise to the English words cholera (from Greek kholé) and melancholia^{[citation needed]}. Those same theories explain the derivation of the English word bilious from bile, the meaning of gall in English as "exasperation" or "impudence", and the Latin word cholera, derived from the Greek kholé, which was passed upon several Romance languages in words meaning "anger" such as colère (French) and cólera (Spanish). These theories derived from the four-element theory. Underlying this is the idea that the organs of the body are connected to the soul, specifically the astral body, and reflect the emotional state of the soul. Thus excess anger, for example, gave rise to liver derangement and imbalances in the humors. This is similar to beliefs in traditional Chinese medicine. In the course of history, medical science helped people to understand diseases better, and the humorism theory fell from use.

Bile soap

Bile from deceased mammals can be mixed with soap. This mixture, called bile soap,^[6] can be applied to textiles a few hours before washing and is a traditional and rather effective method for removing various kinds of tough stains.

Principal bile acids

Cholic acid
Chenodeoxycholic acid
Glycocholic acid
Taurocholic acid
Deoxycholic acid
Lithocholic acid

References

Notes

^ al.], Kim E. Barrett, ... [et (2012). Ganong's review of medical physiology. (24th ed. ed.). New York: McGraw-Hill Medical. p. 512. ISBN 978-0-07-178003-2.
^ Cite error: The named reference undefined was invoked but never defined (see the help page).
^ al.], Kim E. Barrett, ... [et (2012). Ganong's review of medical physiology. (24th ed. ed.). New York: McGraw-Hill Medical. p. 512. ISBN 978-0-07-178003-2.
^ Guyton and Hall (2011). Textbook of Medical Physiology. U.S.: Saunders Elsevier. p. 784. ISBN 978-1-4160-4574-8.
^ Barabote RD, Tamang DG, Abeywardena SN, et al. (2006). "Extra domains in secondary transport carriers and channel proteins". Biochim. Biophys. Acta 1758 (10): 1557–79. doi:10.1016/j.bbamem.2006.06.018. PMID 16905115.
^ Newton, W. (1837). "The invention of certain improvements in the manufacture of soap, which will be particularly applicable to the felting of woollen cloths.". The London Journal Of Arts And Sciences; And Repertory Of Patent Inventions IX: 289. Retrieved 2007-02-08.

Bibliography

Bowen, R. (2001-11-23). "Secretion of Bile and the Role of Bile Acids In Digestion". Colorado State Hypertextbook article on Bile. Archived from the original on 29 May 2007. Retrieved 2007-07-17.
Krejčí, Z; Hanuš L., Podstatová H. & Reifová E (1983). "A contribution to the problems of the pathogenesis and microbial etiology of cholelithiasis". Acta Universitatis Palackianae Olomucensis Facultatis Medicae 104: 279–286. PMID 6222611. Cite uses deprecated parameters (help)
Maton, Anthea; Jean Hopkins; Charles William McLaughlin; Susan Johnson; Maryanna Quon Warner; David LaHart; Jill D. Wright (1993). Human Biology and Health. Englewood Cliffs, New Jersey, USA: Prentice Hall. ISBN 0-13-981176-1.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. ビリルビン代謝 bilirubin metabolism
2. 総胆管損傷の修復 repair of common bile duct injuries
3. 成人における難治性胃食道逆流症へのアプローチ approach to refractory gastroesophageal reflux disease in adults
4. 総胆管診査 common bile duct exploration
5. 栄養の吸収および吸収不良の機序 mechanisms of nutrient absorption and malabsorption

English Journal

A novel (11)C-labeled thymidine analog, [(11)C]AZT, for tumor imaging by positron emission tomography.

Tahara T1, Zhang Z, Ohno M, Hirao Y, Hosaka N, Doi H, Suzuki M, Onoe H.
EJNMMI research.EJNMMI Res.2015 Dec;5(1):124. doi: 10.1186/s13550-015-0124-0. Epub 2015 Sep 4.
BACKGROUND: Nucleoside analogs labeled with positrons, such as (11)C and (18)F, are considered valuable in visualizing the proliferative activity of tumor cells in vivo using positron emission tomography (PET). We recently developed the (11)C-labeled thymidine analogs [(11)C]zidovudine ([(11)C]AZT)
PMID 26337804

Suitability of bovine bile compared to urine for detection of free, sulfate and glucuronate boldenone, androstadienedione, cortisol, cortisone, prednisolone, prednisone and dexamethasone by LC-MS/MS.

Chiesa L1, Nobile M1, Panseri S2, Vigo D1, Pavlovic R1, Arioli F3.
Food chemistry.Food Chem.2015 Dec 1;188:473-80. doi: 10.1016/j.foodchem.2015.04.131. Epub 2015 Apr 29.
The administration of boldenone and androstadienedione to cattle is forbidden in the European Union, while prednisolone is permitted for therapeutic purposes. They are pseudoendogenous substances (endogenously produced under certain circumstances). The commonly used matrices in control analyses are
PMID 26041220

Partially covered versus uncovered self-expandable nitinol stents with anti-migration properties for the palliation of malignant distal biliary obstruction: A randomized controlled trial.

Yang MJ1, Kim JH, Yoo BM, Hwang JC, Yoo JH, Lee KS, Kang JK, Kim SS, Lim SG, Shin SJ, Cheong JY, Lee KM, Lee KJ, Cho SW.
Scandinavian journal of gastroenterology.Scand J Gastroenterol.2015 Dec;50(12):1490-9. doi: 10.3109/00365521.2015.1057219. Epub 2015 Jul 1.
OBJECTIVE: Covered self-expandable metal stents (SEMSs) are increasingly used as alternatives to uncovered SEMSs for the palliation of inoperable malignant distal biliary obstruction to counteract tumor ingrowth. We aimed to compare the outcomes of partially covered and uncovered SEMSs with identica
PMID 26133200

Japanese Journal

PPARγ ligand attenuates portal inflammation in the MRL-lpr mouse: a new strategy to restrain cholangiopathy in primary biliary cirrhosis

Nozaki Yusuke,Harada Kenichi,Sanzen Yasun,Nakanuma Yasuni
Medical Molecular Morphology 46(3), 153-159, 2013-09-00
… Primary biliary cirrhosis (PBC) is characterized by chronic destructive cholangitis, which is associated with the reduced expression of an anti-inflammatory molecule, peroxisome proliferator-activated receptor-γ (PPARγ), in intrahepatic bile ducts. …
NAID 120005253960

Management of postoperative hemorrhage associated with factor VIII inhibitor: report of a case

Onishi Ichiro,Kayahara Masato,Munemoto Masayoshi,Sakai Seisyo,Makino Isamu,Hayashi Hironori,Nakagawara Hisatoshi,Tajima Hidehiro,Takamura Hiroyuki,Kitagawa Hirohisa,Tani Takashi,Ohta Tetsuo
Surgery Today 43(9), 1058-1061, 2013-09-00
… A 71-year-old male who underwent surgery for bile duct cancer had active bleeding in the abdominal drainage tube on postoperative day (POD) 5, and prolonged activated partial thromboplastin time (aPTT) was detected (83.1 s) on POD 7. …
NAID 120004754695

Analysis of the caudate artery with three-dimensional imaging

Oshiro Yukio,Sasaki Ryoko,Takeguchi Takaya,Ibukuro Kenji,Ohkohchi Nobuhiro,大城幸雄,大河内信弘
Journal of hepato-biliary-pancreatic sciences 20(6), 639-646, 2013-08-00
… This study aimed to precisely analyze the caudate artery as well as the relationship between the caudate arteries, the arterial plexus at the hilar plate, and the hilar bile duct.MethodsReconstructed three-dimensional (3D) computed tomography images from 50 patients during hepatic arteriography were analyzed. …
NAID 120005323068

Related Pictures

★リンクテーブル★

リンク元	「胆汁」「bilious」「gall」「biliary」「cholic」
拡張検索	「labile」「bile duct stricture」

「胆汁」

　　[★]

英: bile
関: 肝臓、胆嚢、胆管

0.5-1.0 L/day, pH 8.0-8.6
消化酵素を含まないアルカリ性の分泌液である

分泌部位

部位	胆汁		割合
肝細胞	毛細管胆汁	2/3
胆細管	胆細管胆汁	1/3

分泌経路

肝臓胆汁が総肝管を経由して胆嚢にいたり、ここで濃縮を受けて胆嚢胆汁となる。

機能

1. 脂肪乳化作用

胆汁酸により、直径1μm以下の脂肪滴が形成され、表面積拡大によりリパーゼと反応しやすくなる。

2. ミセルの形成

ミセルの直径5nm。胆汁酸は両親媒性であり親水基と疎水基を持つ。

親水性: OH基,ペプチド結合,カルポキシル基
疎水性: 上記部分以外

胆汁に含まれる胆汁酸とリン脂質により、モノグリセリド・脂肪酸とミセルを形成することができる。

3. コレステロールとビリルビンの排出
4. 胃酸の中和

組成

1. 胆汁酸

see HBC.236

　　1次胆汁：コレステロールより合成
　　　　コール酸
　　　　キノデオキシコール酸
　　2次胆汁：1次胆汁の腸内細菌による代謝(7位の部位のOH基が除去される)
　　　　デオキシコール酸
　　　　リトコール酸
　　3次胆汁：肝臓から分泌される状態(可溶性)
　　　　タウロコール酸(タウリンと抱合)
　　　　グリココール酸(グリシンと抱合)

2. 胆汁色素

　　ビリルビン：Hbの代謝産物
　　間接型(不溶性)
　　↓←グルクロン酸抱合
　　直接型(水溶性)(抱合型ビリルビン)
　　↓
　　ウロビリノーゲン(腸管)
　　↓
　　ステルコピリン(腸管)
　　↓
　　排泄

3. 脂質

　　リン脂質(主にレシチン)
　　　　不溶性であるが胆汁酸存在下でミセル形成(可溶性)
　　コレステロール
　　　　不溶性であるが胆汁酸存在下でミセル形成(可溶性)

4.電解質成分

　　陽イオン：Na+(主)、その他K+,Ca2+
　　陰イオン：Cl-,HCO3-(アルカリ性)

胆汁の分泌と排出

1. 毛細管胆汁　1-1. 胆汁酸依存性胆汁　　　胆汁酸と水分の分泌：胆汁酸の腸肝循環に依存。　　　腸肝循環：肝臓から分泌された胆汁が小腸で吸収され、門脈を経て肝臓に戻り、再び排泄されること。　　　タウロコール酸・グルココール酸　　　　　陰イオンに解離しやすく吸収されやすい。　　　リトコール酸　　　　　非解離型なので糞便中に排泄される。　　　分泌された胆汁酸の95％は腸肝循環により再利用される。

　1-2. 胆汁酸非依存性胆汁　　　胆汁酸以外の分泌：Na＋,K+,Ca2+,Cl-,HCO3-,ビリルビン(有機陰イオン) 　　　等張性　　　　　：Na+,Cl-,HCO3-は血漿濃度に類似

2. 胆細管胆汁　2-1. Na+,HCO3-(高濃度),水の分泌---セクレチンによる　2-2. Na+,Cl-の吸収

3. 胆汁の濃縮(胆嚢) 　　電解質吸収(Na+,Cl-の能動的吸収)とそれに伴う水の吸収→5-50倍に濃縮

4. 胆汁排出　　食後30分で胆嚢収縮開始。液性の調節機構による排出が主である。　4-1. 液性　　十二指腸内食物→CCK分泌→オッディ括約筋弛緩・胆嚢収縮　　十二指腸内食物→セクレチン分泌→CCKの作用に拮抗　　胃内食物→ガストリン分泌→胆嚢収縮　4-2. 神経性　　迷走神経性反射→オッディ括約筋弛緩,胆嚢収縮(関与の程度不明)