Roles of infection, inflammation, and the immune system in cholesterol gallstone formation

Gastroenterology. 2009 Feb;136(2):425-40. doi: 10.1053/j.gastro.2008.12.031. Epub 2008 Dec 25.


Cholesterol gallstone formation is a complex process mediated by genetic and environmental factors. Until recently, the role of the immune system in the pathogenesis of cholesterol gallstones was not considered a valid topic of research interest. This review collates and interprets an extensive body of basic literature, some of which is not customarily considered to be related to cholelithogenesis, describing the multiple facets of the immune system that appear to be involved in cholesterol cholelithogenesis. A thorough understanding of the immune interactions with biliary lipids and cholecystocytes should modify current views of the pathogenesis of cholesterol gallstones, promote further research on the pathways involved, and lead to novel diagnostic tools, treatments, and preventive measures.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Bacterial Infections / complications
  • Cholecystitis / physiopathology*
  • Cholesterol / metabolism
  • Disease Models, Animal
  • Gallbladder Diseases / physiopathology*
  • Gallstones / microbiology
  • Gallstones / pathology
  • Gallstones / physiopathology*
  • Humans
  • Inflammation
  • Lipid Metabolism / physiology
  • Mice


  • Cholesterol