Gallbladder disease is one of the most common digestive disorders, and hallmark properties include
decreased contractility, inflammation, and gallstone formation. Three features are consistently associated with
gallstone disease: (1) elevated cholesterol hydrophobic salt and triglyceride (TG) levels in the bile; (2)
inflammation of the gallbladder; and (3) impairments in gallbladder tone and contractility. Nevertheless, the
interrelationships between decreased gallstone formation, inflammation, and contractility are not understood,
and this reflects our lack of understanding of the cellular events that lead to decreased resting tone and
postprandial contractions in gallbladder disease. This grant application proposes to address these fundamental
gaps in our knowledge. The overall objectives of this grant application are to: (1) elucidate the cellular and
ionic mechanisms by which gallbladder smooth muscle (GBSM) contractility is disrupted in gallstone disease;
(2) determine the role of inflammation in smooth muscle dysfunction and associated biliary stasis in gallstone
disease; and (3) explore the utility of hydrophilic bile salts in the protection of gallbladder function by preventing
or reversing these disruptions to GBSM. We will use wild type and transgenic mice fed a lithogenic (gallstone
forming) diet to evaluate the functional changes that occur in GBSM and interstitial cells of Cajal (ICC) during
the progression of gallstone disease in normal mice and mice that do not develop gallbladder inflammation.
We will also evaluate GBSM function in mice fed a lithogenic diet while being treated with a cyclooxygenase
inhibitor, or the protective hydrophilic bile salt, ursodeoxycholic acid (UDCA). The second model involves
evaluation of the effects of cholesterol and hydrophobic bile salts applied in vitro to gallbladder muscularis
preparations, with or without prior application of UDCA. This approach allows us to examine the actions of
these compounds, individually or together, on GBSM and ICC in a controlled environment.
This grant proposal involves an integrated approach using state-of-the-art techniques to investigate
gallbladder pathophysiology from single molecules to intact tissue during the progression of disease in the
animal. Techniques to be used include optogenetic Ca2+ imaging of GBSM cells and ICC in intact muscle
bundles, intracellular and patch clamp recording from intact and isolated GBSM cells, respectively, and
muscularis tension measurements. Together with our previous studies on smooth muscle function, we will
provide insights on how gallbladder motor function is disrupted leading to biliary stasis, and the
interrelationship between disrupted motor function and inflammation. Furthermore, these studies will elucidate
the therapeutic potential of UDCA to prevent or reverse cellular changes in GBSM/ICC that underlie decreased
gallbladder contractility, and uncover the cellular mechanisms that mediate their actions in the gallbladder.