Bile acid alterations in biliary obstruction patients with Clonorchiasis.

BACKGROUND Clonorchiasis, is a significant foodborne zoonotic parasitic disease that leads to severe complications such as cholecystitis, liver cirrhosis, and biliary obstruction (BO). Abnormalities in bile acids (BAs) play a crucial role in BO progression. Nevertheless, the abnormalities in BAs and their role in BO patients with Clonorchis sinensis (C. sinensis) infection remain inadequately understood.

METHODS This study included BO patients with or without C. sinensis infection. Bile samples were collected via Endoscopic Retrograde Cholangiopancreatography (ERCP) and bile acid (BA) profiles were analyzed by liquid chromatography electrospray ionization tandem mass spectrometry (LC-MS/MS). Biliary microbiota was analyzed through high-throughput 16S ribosomal RNA (16S rRNA) gene sequencing. Spearman correlation assessed associations between BA, biochemical markers, and biliary microbiota.

RESULT Metabolomic analysis revealed that the levels of chenodeoxycholic acid (CDCA), ursodeoxycholic acid (UDCA), hyodeoxycholic acid (HDCA), and 3β-cholic acid (βCA) were significantly reduced in C. s-infected group and positively correlated with Enterococcus abundance. Furthermore, the levels of alkaline phosphatase (ALP) demonstrated a strong positive correlation with CA (cholic acid)/CDCA (r = 0.74, P = 0.01) and (CA+deoxycholic acid [DCA])/(CDCA+lithocholic acid [LCA]) (r = 0.75, P = 0.01) in the C. s-infected group.

CONCLUSIONS BO patients infected with C. sinensis displayed BA profiles, with reduced CDCA, UDCA, HDCA, and β-CA levels correlating with Enterococcus abundance. These preliminary findings suggest an interaction among BA metabolism, the biliary microbiota, and liver damage associated with parasitic infection.