Biliary IgA secretion in obstructive jaundice: The effects of endoscopic drainage

Sung, Joseph J.Y.; Leung, Joseph C.K.; Tsui, CP; Chung, Sukyung; Lai, Kar Neng

doi:10.1016/s0016-5107(95)70047-1

Cited by 18 publications

(8 citation statements)

References 13 publications

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“…And so Csendes states that in his material bile infection in bile ducts during the course of choledocholithiasis without symptoms of bile duct infl ammation occurred in 58% of patients, yet in patients with symptoms of infected bile during the course of choledocholithiasis ranged between 93% and 100% (40). Higher rate of patients with infected bile during the course of choledocholithiasis is also stated by Ohdan and Sung, in whose studies it equalled respectively 83% and 73% (41,48).…”

Section: Discussionmentioning

confidence: 76%

Bile Infection and Bile Acids Concentration in Bile in Acute Biliary Pancreatitis

Zasada¹,

Panek²,

Dolecki³

et al. 2009

Polish Journal of Surgery

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Biliary stones are the most common etiology of acute pancretitis (AP). Pathomechanism of this etiology is based on common channel theory of Opie. Material and methods. 113 patients with ABP were included in the study -91 with mild and 22 with severe form of ABP. 17 patients with cholelithiasis and choledocholithiasis without ABP served as controls. All the patients were submitted to the same model of treatment. Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sfi ncterotomy (ES) were performed in the day of admission and laparoscopic cholecystectomy within the next 24 hours. Bile specimens were taken from main bile duct (MBD) during ERCP and from gall-bladder (GB) during laparoscopic cholecystectomy. Bacteriological cultures, bile acids (BA) concentration and total and secretory form of IgA concentration were assessed in particular groups of patients. Results. No signifi cant statistical differences of bile infection in MBD and GB were found between the analyzed groups of patients. Furthermore, the bile among the patients with severe ABP was more frequently infected, particularly when obtained from gall-bladder. Most common pathogens found in cultures were Gram negative bacteria. Interestingly, Gram positive cultures and fungi were also signifi cant. The number of species of pathogens was of no signifi cance for infection concerning both: source of bile and groups of patients. Mean concentrations of total BA were different between study groups of patients in MBD and in GB. It is worth mentioning, that the fraction of hydrophobic, secondary BA which are potentially more toxic, was increased in total concentration of BA in MBD particularly in patients with severe form of AP. Among patients with mild AP and controls these values were lower and similar. Conclusions. It seems that BA play as an aggressive factor during AP while in physiologic condition have a protective, antibacterial meaning.

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Section: Discussionmentioning

confidence: 76%

Bile Infection and Bile Acids Concentration in Bile in Acute Biliary Pancreatitis

Zasada¹,

Panek²,

Dolecki³

et al. 2009

Polish Journal of Surgery

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“…We further investigated whether cholestasis influences IgA or IgG ANCA secretion. Sung et al described in 1995, that biliary obstruction causes suppression of bile IgA secretion [27]. Therefore, we performed a statistical analysis by comparing cholestatic parameters of PSC patients with IgA and IgG ANCA positivity versus PSC patients negative for IgA and IgG ANCA.…”

Section: Discussionmentioning

confidence: 99%

Antineutrophil cytoplasmic antibodies in bile are associated with disease activity in primary sclerosing cholangitis

Lenzen

Weismüller

Negm

et al. 2013

Scandinavian Journal of Gastroenterology

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OBJECTIVE. Primary sclerosing cholangitis (PSC) is an autoimmune cholestatic liver disease of unknown etiology. The role of antineutrophil cytoplasmic antibodies (ANCAs) in the serum of patients with PSC remains unclear. We hypothesized that ANCA may be detectable in bile, potentially providing diagnostic and prognostic information. METHODS. Serum and bile were prospectively collected during endoscopic retrograde cholangiography (ERC) in 72 patients with PSC and other non-PSC obstructive biliary diseases. ANCA measurements were performed by indirect immunofluorescence (IIF). RESULTS. Immunoglobulin G (IgG) ANCA was detected significantly more often in the bile of PSC patients (15/39; 38%) than without (2/33; 6%) (p = 0.001). IgG ANCA in bile was associated with a ten times higher risk of PSC (p = 0.005). In addition, IgG ANCA positivity in bile was associated with the presence of dominant strictures (p = 0.03), cholangiographic severity (p = 0.004), number of ERC (p = 0.01) and interventions performed (p = 0.03). However, IgG ANCA in bile did not correlate with transplantation, cholangiocarcinoma or death. No association was observed between ANCA positivity in sera and ANA and ASCA positivity in sera or bile with the above-mentioned clinical features. CONCLUSIONS. The presence of ANCA in the bile of patients with PSC is a novel finding and highly suggestive of PSC. Biliary IgG ANCA correlates with the severity of bile duct strictures and the ensuing number of ERCs and interventions. Therefore, a positive ANCA status in bile may serve as a diagnostic and prognostic marker of the disease progression and biliary complications.

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“…IgA is the predominant immunoglobulin in bile. Sung et al [29] have reported that biliary obstruction secondary to both calculus and malignancy causes suppresion of bile IgA secretion. Similar result is observed in the present study.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Immunity Status in Patients with Pancreatic Cancer

Geetha

Jeyachristy

Surendran

2006

J. Clin. Biochem. Nutr.

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Summary Wound infection and abscess are the common post operative complications in pancreatic cancer patients. The aim of this study was to evaluate the status of immunity in patients with cancer in the head of pancreas by analyzing the levels of immunoglobulins, compliments, acute phase reactants and the efficiency of neutrophils for phagocytosis. The study was conducted on 89 patients with cancer in the pancreatic acini /pancreatic duct/ head of pancreas/ periampullary region and on equal number of age and sex matched normal healthy volunteers. All the patients were in a need to undergo either pancreaticoduodenectomy or duodenal preserving resection of head of the pancreas. The levels of IgM, IgA, IgE, C3, C4, C-reactive proteins, haptaglobin, α2 macroglobulin were assayed in the blood samples. The level of phagocytosis and bactericidal activity were evaluated in neutrophils. The level of IgM was significantly low and the levels of IgA and IgE were significantly high in pancreatic cancer patients. The levels of C-reactive protein, haptaglobin, α2 macroglobulin , C3 and C4 were elevated significantly. The phagocytic efficiency and the bactericidal action of polymorphonuclear lymphocytes and mononuclear cells were low in pancreatic cancer patients when compared to normal control subjects. In pancreatic cancer patients the antibody mediated immunity is disturbed and the acute phase response is stimulated to counteract the infection and the abnormal metabolites released from malignant cells. The functional impairment of phagocytes might be responsible for the post operative complications in pancreatic cancer patients.

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Biliary IgA secretion in obstructive jaundice: The effects of endoscopic drainage

Cited by 18 publications

References 13 publications

Bile Infection and Bile Acids Concentration in Bile in Acute Biliary Pancreatitis

Bile Infection and Bile Acids Concentration in Bile in Acute Biliary Pancreatitis

Antineutrophil cytoplasmic antibodies in bile are associated with disease activity in primary sclerosing cholangitis

Assessment of Immunity Status in Patients with Pancreatic Cancer

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