Quantifying Serum Level of Glycochenodeoxycholic Acid Using High Performance Liquid Chromatography in Obstructive Jaundice Patients

Introduction. Accumulation of glycochenodeoxycholic acid (GCDC) in serum has a clinical significance as an inductor of pathological hepatocyte apoptosis, which impairs liver function. Inhibition of GCDC accumulation can be used as a marker in therapy. This study was aimed to quantify the serum level of GCDC in obstructive jaundice patients. Methodology. GCDC acid level in the serum was quantified using high performance liquid chromatography (HPLC) technique according to Muraca and Ghoos modified method. It was performed before and after decompression at day 7 and day 14. The sample was extracted with solid phase extraction (SPE) technique on SPE column. The results were analyzed using SPSS V 16.0 ( ) and quantified with standard curve on GCDC acid. Result. There were 21 cases with range of GCDC acid serum level before decompression was 90.9 (SD 205.5) μmol/L and day 7 after decompression decreased to 4.0 (SD 46.4) μmol/L and then increased to 11.3 (SD 21.9) μmol/L ( ). This method could separate GCDC acid on serum with good resolution, high precision and accuracy, and linear calibration curve on measured level range. Conclusion. HPLC can quantify GCDC acid serum on obstructive jaundice patients and can be used to support its pharmacokinetic study. 1. Introduction The accumulation of glycochenodeoxycholic (GCDC) acid in obstructive jaundice patients is cytotoxic, can harm hepatocytes, and impairs liver function [1, 2]. GCDC acid is a primary biliary acid directly divided from cholesterol in hepatocytes and conjugated with amino acid glycyne or taurin and becomes a conjugate of glycine or taurin [3, 4]. GCDC acid, as a dose dependent inductor of apoptosis in hepatocyte and kinase protein C, can be used as a parameter of pathological apoptosis of hepatocyte and impaired liver function [5]. Several methods can be used to measure biliary acid level in the body fluid (serum or biliary fluid). Enzyme immunoassay method, which is mostly used to measure the total level of biliary acid, cannot be applied to measure primary, secondary, and tertiary biliary acid distinctively [6]. Liquid or gas chromatography is the chosen method for quantifying level of biliary acid [1]. Several animal studies have shown that high performance liquid chromatography (HPLC) can measure GCDC acid serum faster and precisely [6]. This study measures the GCDC acid serum in severe obstructive jaundice patients through biliary tract decompression models, using Muraca and Ghoos modified methods. 2. Methodology This study was performed on obstructive jaundice patients, mostly due to