Correlation between alkaline phosphatase, g-glutamyl transpeptidase, and bilirubin with interleukin-1b level in dogs with obstructive jaundice

Abstract

Surgical management in obstructive jaundice still contributes to significant morbidity and mortality. One of complications following surgery in obstructive jaundice is sepsis. This complication is caused by the toxic effects of bilirubin and bile salts, endotoxins, bacterial translocation, modulation of the immune-inflammatory cascade, decreased cellular immunity and/or nutritional status. Many studies have shown the elevated inflammatory response indicator, interleukin-1 (IL-1b), in patients with obstructive jaundice. However, only a few report described the association between the indicators of obstructive jaundice (alkaline phosphatase [ALP], g-glutamyl transpeptidase [GGT], and bilirubin) and the indicator of inflammatory response ). This study aimed to investigate the association between the indicator of obstructive jaundice (ALP, GGT, and bilirubin) and the level of interleukin-1b (IL-1b) in dogs as the animal model. We performed ligation on distal common bile ducts (CBD) to produce a model of obstructive jaundice. Every three days within a month, the blood samples from ten dogs were extracted to determine the ALP, GGT, direct and total bilirubin, and IL-1b levels. We found a significant correlation between the ALP and GGT with IL-1b level with p-value of 0.036 (r=0.626) and 0.003 (r=0.826). However, there was no association between the increased direct bilirubin with the IL-1b level (p=0.068; r=0.537). Moreover, the increased level of ALP and GGT had a strong correlation with the increased level of direct bilirubin with p-value of 0.004 (r=0.810) and p=0.011 (r=0.746). In conclusion, the increased level of GGT was the strongest indicator for inflammatory response in dogs with obstructive jaundice. Furthermore, the increased levels of GGT and ALP might imply the development of obstructive jaundice in dogs.

Experimental Extrahepatic Cholestasis in Dogs: Ultrasonographic, Biochemical and Histopathological Study

“…The main reason for the obvious increase in liver enzymes is the severe damage occurred to the liver tissue secondary to common bile duct ligation and their leakage into blood stream, these results were similar to the results recorded by Jiang et al 2016, who mentioned that liver enzymes were significantly increase 3 days after common bile duct ligation. Also, the serum GGT and ALP showed significant increase after common bile duct ligation, this increase is attributed to marked damage occurred in biliary system secondary to severe distension of cystic, hepatic and common bile ducts due to extensive accumulation of bile and prominent leakage of these enzymes to systemic circulation, these findings agreed with Setyawan and Budipramana (2015), who mentioned that the increased levels of GGT and ALP occurred three days after ligation of the CBD, then fluctuated until day 29.…”

“…Significant increase in the mean values of serum total and direct bilirubin after ligation starting from the 3 rd day till reach the peak at the 2 nd week post-surgery, then the level began to decrease from the 3 rd week till reaching the lowest level at the 8 th week compared to 0 day level, these results were in accordance with that obtained by Crema et al (2007), who recorded that common bile duct ligation in dog resulted in increase in total bilirubin after one week post-surgery. Setyawan and Budipramana (2015) mentioned that the level of direct and total bilirubin showed significant increases from the 3 rd day, with a reduction on day 14, and increased again until day 29.…”

A Comparative Study of Serum Gamma-Glutamyl Transpeptidase, Serum Alkaline Phosphatase and GGT/ALP Ratio in Different Liver Disorder

“…In cholestatis, there is increased synthesis of ALP and GGT and their solubility and hence leaks out of the bile duct due to increased bile pressure. 22 Although there were higher levels of GGT in patients with obstructive jaundice as compared to patients with AAH, this increase was not statistically significant. This could be explained by the fact that in alcoholics, increase in GGT is more due to induction by ethanol rather than obstruction or hepatic injury.…”