Development and reversibility of T lymphocyte dysfunction in experimental obstructive jaundice

Thompson, R. L. E.; Hoper, Margaret; Diamond, T.; Rowlands, B. J.

doi:10.1002/bjs.1800771112

Cited by 60 publications

(34 citation statements)

References 20 publications

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“…The detailed mechanism of suppressed Tlymphocyte proliferation is unclear (13,18). Various plasma circulating inhibitory factors such as bile acids, cytokine, bilirubin, endotoxin, and lipoproteins are possible causes of T-lymphocyte defects (19). High serum bile acids have been shown to inhibit lymphocyte proliferation in a previous study (20).…”

Section: Discussionmentioning

confidence: 99%

Impaired T-Lymphocyte Proliferation Function in Biliary Atresia Patients With Chronic Cholestatic Jaundice After a Kasai Operation

Chiang

Chen

et al. 2006

Pediatr Res

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ABSTRACT:To investigate the association between chronic cholestatic jaundice, systemic immunity, and various infectious complications in patients with biliary atresia (BA), we performed a survey of the systemic immune function in 30 children with BA. Patients were divided into a jaundice group (total serum bilirubin Ն2 mg/dL for Ͼ6 mo) and control group (total serum bilirubin Ͻ2 mg/dL for Ͼ6 mo) with comparable age. Patients were tested for serum immunoglobulin and complement levels, mitogen response, interleukin (IL)-4, IL-5, and interferon-gamma production after phytohemagglutinin (PHA) stimulation, blood cell and lymphocyte subpopulation counts, phagocytic function, and leukocyte adhesion complex. They were then followed prospectively for 6 mo, and severe infectious complications requiring hospitalization were recorded. Compared with jaundice-free patients, T-lymphocyte proliferation function, determined by PHA mitogen test was significantly lower (p ϭ 0.02) in BA patients with chronic cholestatic jaundice after a Kasai operation. During the study period, patients with chronic cholestatic jaundice had a higher risk of severe infectious complications than their jaundice-free counterparts (risk ratio ϭ 5.87; p ϭ 0.001). In conclusion, BA patients with chronic cholestatic jaundice are associated with impairment of T-lymphocyte proliferation and increased incidence of severe infectious complications.

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Section: Discussionmentioning

confidence: 99%

Impaired T-Lymphocyte Proliferation Function in Biliary Atresia Patients With Chronic Cholestatic Jaundice After a Kasai Operation

Chiang

Chen

et al. 2006

Pediatr Res

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“…Deitch et al [1,2,22] and Thompson et al [23] reported that bacterial translocation from the gut impairs systemic cell-mediated immunity. The immune state of the CBD ligated mice could influence their susceptibility to bacterial translocation, and loss of intestinal barrier function results in a state of acquired systemic immune suppression in obstructive jaundice.…”

Section: Discussionmentioning

confidence: 99%

Effect of Different Enteral Nutrients on Bacterial Translocation in Experimental Obstructive Jaundice

Kuru¹,

Dinç²,

Altınok

et al. 2004

Eur Surg Res

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Obstructive jaundice leads to bacterial translocation (BT) by disruption of the gut barrier, intestinal microecology, and impaired host immune defence. The objective of the present study is to investigate the effects of different enteral nutrients on BT that is induced by obstructive jaundice in rats. Eighty male Wistar-Albino rats were randomly assigned into 4 groups. Group 1: 20 rats underwent laparotomy, common bile duct (CBD) was not actually ligated and transected, but sham ligation of CBD was performed. Groups 2–4: 60 rats underwent laparotomy, CBD ligation and transection. Group 1 and 2 rats were given rat chow, group 3 rats were fed a glutamine and arginine supplemented enteral diet, and group 4 rats were fed an arginine, m-RNA and ω-3 supplemented enteral diet, an immunonutrient. Rats in groups 3 and 4 had significantly less BT to mesenteric lymph nodes compared to rats in group 2 (p = 0.001). These findings suggest that oral administration of an arginine and glutamine supplemented diet and immunonutrition reduce BT in rats with obstructive jaundice.

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“…Restoration of bile into the normal enterohepatic circulation resulted in reduced rates of postoperative death [8], endotoxaemia [9], and renal impairment [10], more rapid recovery of cell-mediated immunity [11], and better regeneration rate of liver cells after hepatectomy [12]. …”

Section: Experimental Studiesmentioning

confidence: 99%

Preoperative Biliary Drainage before Resection in Obstructive Jaundice

Aly¹,

Johnson²

2001

Dig Surg

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Background: Surgery for patients with malignant obstructive jaundice carries high morbidity and mortality rates. Preoperative biliary drainage (PBD) has been used in an attempt to improve the outcome in these patients. Aim: To review the evidence in the literature on whether PBD improves postoperative morbidity and mortality in obstructive jaundice patients. Method: Using Medline a literature search was performed for papers published in English from January 1980 to October 2000, using the text words ‘obstructive jaundice’, ‘preoperative’, ‘drainage’ and ‘stent’. All retrieved papers which reported experimental or clinical observations relevant to the study aim were carefully analysed and the findings are summarised in this review. Results and Conclusion: There is no evidence in the literature to support the view that routine PBD improves postoperative morbidity and mortality in patients with obstructive jaundice undergoing resection. PBD has its own complications that cancel out its benefits. However, PBD could be beneficial in patients presenting with sepsis, coagulation abnormalities or malnutrition.

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Development and reversibility of T lymphocyte dysfunction in experimental obstructive jaundice

Cited by 60 publications

References 20 publications

Impaired T-Lymphocyte Proliferation Function in Biliary Atresia Patients With Chronic Cholestatic Jaundice After a Kasai Operation

Impaired T-Lymphocyte Proliferation Function in Biliary Atresia Patients With Chronic Cholestatic Jaundice After a Kasai Operation

Effect of Different Enteral Nutrients on Bacterial Translocation in Experimental Obstructive Jaundice

Preoperative Biliary Drainage before Resection in Obstructive Jaundice

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