Tedros Bezabeh1, Omkar B. Ijare1, Nils Albiin2, Urban Arnelo3, Bo Lindberg2, Ian CP Smith1
1National Research Council Institute for Biodiagnostics, Winnipeg, Manitoba, Canada; 2Radiology, Karolinska Institutet, Stockholm, Sweden; 3Surgery, Karolinska Institutet, Stockholm, Sweden
Bilirubin is a major biliary pigment mostly present in conjugation with glucuronic acid as bilirubin diglucuronide. Bilirubin diglucuronide may be hydrolyzed in the presence of β-glucuronidase releasing free bilirubin and D-glucuronic acid into the bile. Bilirubin is reabsorbed into the body, but glucuronic acid is retained in the bile and could be analyzed. We report here a simple 1H MRS method for the detection and quantification of D-glucuronic acid in human bile. The bile samples from various patients with biliary obstruction (controls), chronic pancreatitis and pancreatic cancer have been analyzed by the proposed method. The study revealed elevated levels of D-glucuronic acid in pancreatic cancer patients, whereas D-glucuronic acid was absent or negligible in control and pancreatitis patients. This observation could have a diagnostic potential in the detection of pancreatic cancer.