Lymph, bilirubin

Part of the cholesterol newly synthesized in the liver is excreted into bile in a free non-esterified state (in constant, amount). Cholesteiol in bile is normally complexed with bile salts to form soluble cholic acids, Free cholesterol is not readily soluble and with bile stasis or decreased bile salt concentration may precipitate as gallstones. Most common gallstones are built of alternating layers of cholesterol and calcium bilirubin and consist mainly (80-90%) of cholesterol. Normally. 80% of hepatic cholesterol arising from blood or lymph is metabolized to cholic acids and is eventually excreted into the bile in the form of bile salts. 

C2. Carlsten, A., Edlund, Y., and Thulesius, 0., Bilirubin, alkaline phosphatase and transaminases in blood and lymph during biliary obstruction in the cat. Ada Physiol. Scand. 63, 58-67 (1961). 

There is a large production of hepatic lymph which appears to arise by passage of fluid from the perisinusoidal space, from bile duct area and in the portal tract area (A12). It has been suggested that blood, lymph, and bile enter into an equilibrium in the portal tract (Review article, 2). The lymphatics could also act as a transport system between the liver lobule and the biliary epithelium (All). A detailed study of the relative concentrations of BSP and its metabolites in lymph, bile, and plasma indicated that the composition of lymph differs from that of bile and plasma (K20). Thus, it seems unlikely that lymphatics were the transport system for BSP from liver cells to bile. During biliary stasis there is a rapid rise in lymphatic BSP levels (B32, G12) and the relative concentrations of BSP metabolites approach those found in bile (K20). On ligation of the bile duct the level of bilirubin and bile acids in lymph also rises (G12) as does the plasma level of BSP (BIO) and rose bengal (B22). 

Hemoglobin and bilirubin interfere minimally with the estimation (H27). With turbid samples, the procedure devised by Gaebler (Gl) for use with BSP has been used. This involves measurement at 680 and 800 m/i. In analyzing intestinal lymph, ethanol has been used to precipitate protein and dissolve fat. The dye was then measured at 780 m/i (H28). 

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