The Pathophysiology of Biliary Obstruction and Its Effect on Phagocytic and Immune Function

Scott‐Conner, Carol E. H.; Grogan, James B.

doi:10.1006/jsre.1994.1151

Cited by 146 publications

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“…An abdominal midline incision was made, and the common bile duct was ligated and divided as described previously. 2 Control animals underwent a sham procedure in which the common bile duct was exposed but not ligated.…”

Section: Methodsmentioning

confidence: 99%

“…[1][2][3][4] Dysfunction of phagocytes and bacterial translocation from the gut due to loss of mucosal integrity are believed to be responsible for septic complication in patients with obstructive jaundice. 1,[5][6][7][8] It has been reported that proinflammatory cytokines, such as tumor necrosis factor ␣ (TNF-␣) and interleukin (IL) 6, are increased in sera without any exogenous stimuli in cholestatic conditions, suggesting that cholestasis evokes inflammatory reaction in the host.…”

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confidence: 99%

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Kupffer cell-derived interleukin 10 is responsible for impaired bacterial clearance in bile duct-ligated mice

et al. 2004

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Extrahepatic cholestasis often evokes liver injury with hepatocyte apoptosis, aberrant cytokine production, and-most importantly-postoperative septic complications. To clarify the involvement of aberrant cytokine production and hepatocyte apoptosis in impaired resistance to bacterial infection in obstructive cholestasis, C57BL/6 mice or Fas-mutated lpr mice were inoculated intraperitoneally with 10 7 colony-forming units of Escherichia coli 5 days after bile duct ligation (BDL) or sham celiotomy. Cytokine levels in sera, liver, and immune cells were assessed via enzyme-linked immunosorbent assay or real-time reverse-transcriptase polymerase chain reaction. BDL mice showed delayed clearance of E. coli in peritoneal cavity, liver, and spleen. Significantly higher levels of serum interleukin (IL) 10 with lower levels of IL-12p40 were observed in BDL mice following E. coli infection. Interferon ␥ production from liver lymphocytes in BDL mice was not increased after E. coli infection either at the transcriptional or protein level. Kupffer cells from BDL mice produced low levels of IL-12p40 and high levels of IL-10 in vitro in response to lipopolysaccharide derived from E. coli. In vivo administration of anti-IL-10 monoclonal antibody ameliorated the course of E. coli infection in BDL mice. Furthermore, BDL-lpr mice did not exhibit impairment in E. coli killing in association with little hepatic injury and a small amount of IL-10 production. In conclusion, increased IL-10 and reciprocally suppressed IL-12 production by Kupffer cells are responsible for deteriorated resistance to bacterial infection in BDL mice. Fasmediated hepatocyte apoptosis in cholestasis may be involved in the predominant IL-10 production by Kupffer cells. (HEPATOLOGY 2004;40:414 -423.)

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Kupffer cell-derived interleukin 10 is responsible for impaired bacterial clearance in bile duct-ligated mice

et al. 2004

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“…However, in recent years, there was an increase in the diagnosis of asymptomatic lithiasis due to upgrading diagnostic methods routinely performed in patients [14][15][16][17] . Because of its frequency, many researchs are conducted to expand the knowledge about the pathogenesis and improving treatment of this disease 14,15,[18][19][20][21][22][23][24] . The treatment of biliary obstructions depends on the time between occurrence and diagnosis of the injury and, the type, extent and location of same in the bile ducts 14,25 , being the surgical treatment the most recommended 2,26 .…”

Section: Introductionmentioning

confidence: 99%

Comparative study between ligature with thread or metallic clamping by means of laparoscopy with the purpose of experimental biliary obstruction in swines

et al. 2011

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PURPOSE: To induce a total extra-hepatic obstructive jaundice in swines, by ligation of the common bile duct by laparoscopic surgery. METHODS: Eight swines of the Landrace race, 36-day-old, originated from the same matrix, distributed in two groups. Group A: was used titanium metal clip to the common bile duct ligation in three animals; group B: were ligated with 2-0 cotton thread in five animals. RESULTS: The ligation of the biliary ducts was performed successfully in all animals, with easy identification of the common bile duct by laparoscopy. There weren't difficulties in the procedures, mainly due to the increased surgical field provided by the excellent quality of light and image of the appliance. The clinical signs of jaundice were evident in the animals in seven days. In group A, two animals showed bile duct perforation near the clip, probably due to ischemic necrosis, progressing to peritonitis and death. In group B, five animals showed obstructive jaundice without any amendment. CONCLUSION: Under the conditions of this study, we therefore recommend the use of unabsorbed wires to experimental biliary obstruction, in order to avoid complications, such as ischemia and necrosis, followed by perforation of the wall of the bile ducts.

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“…The clinical and experimental studies indicate that the specific and non-specific immunity becomes weaker during obstructive jaundice. These studies show that, RES function, macrophage activity, kupfer cell function and natural killer (NK) cell activity decrease [1,11].…”

Section: Discussionmentioning

confidence: 95%

“…Since the bile is not in the intestinal system on obstructive jaundice, the bacterial translocation occurs as the result of excessive bacterial reproduction and endotoxemia. The participation of mucosal, cell-mediated and humoral immunity exists on the prevention of the bacterial translocation through the gastrointestinal tract [11,12]. The clinical and experimental studies indicate that the specific and non-specific immunity becomes weaker during obstructive jaundice.…”

Section: Discussionmentioning

confidence: 99%

Effect of beta-glucan in preventing bacterial translocation in a model of experimental obstructive jaundice

Polat¹,

Dinelek²

2012

CMJ

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Aim. Sepsis is the major cause of post-operative morbidity and mortality in obstructive jaundice as a result of bacterial translocation from the gut. This study was conducted to investigate the effect of beta-glucan in preventing bacterial translocation in an animal model where obstructive jaundice was developed by common bile duct ligation. Methods. Forty-five Wistar-albino rats were divided into three groups of fifteen animal each. Only laparotomy was administered to the first group. Bile duct ligation was administered to the second group. Bile duct ligation and oral beta-glucan for ten days were administered to the third group. The animals were sacrified at the end of the tenth day. Blood, liver, spleen and mesenteric lymph nodes were cultured. The samples taken from terminal ileum and liver were examined histopathologically. Aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), total bilirubin, direct bilirubin and C-reactive protein (CRP) analyses were done on the blood samples taken from the rats. Results. In the first group bacterial translocation was observed in one animal whereas bacterial translocation was observed in twelve animals in II'nd group. In third group bacterial translocation was determined in six animals that received beta-glucan. The differences between these three groups were statistically significant (p<0.05). According to biochemical data only the decrease of ALP and total bilirubin values between group two and three were statistically significant (p<0.05). After the histopathological examination of liver and terminal ileum, no significant difference between group two and three was observed (p>0.05). Conclusion. The result of this study showed that beta-glucan, as a natural immune system activator, has an effect in preventing bacterial translocation in obstructive jaundice. Keywords: Obstructive jaundice, bacterial translocation, beta-glucan ÖzetAmaç. Sepsis, barsaktan kaynaklanan bakteriyel translokasyonun bir sonucu olarak tıkanma sarılığında post-operatif morbidite ve mortalitenin en önemli sebebidir. Bu çalışma, ortak safra kanalı ligasyonu yoluyla tıkanma sarılığı geliştirilen bir hayvan modelinde bakteriyel translokasyonun önlenmesinde beta-glukanın etkisi araştırmak için yapılmıştir. Yöntem. Kırk beş adet Wister albino rat, her birinde onbeş hayvanın bulunduğu üç gruba ayrıldı. I.gruba sadece laparatomi yapıldı. II. gruba safra kanalı ligasyonu yapıldı. III. gruba ise safra kanalı ligasyonu ve on gün beta-glukan oral verildi. Onuncu günün sonunda hayvanlar sakrifiye edildi. Kan, karaciğer, dalak ve mezenter lenf nodu kültürleri ekildi. Terminal ileum ve karaciğerden alınan örnekler histopatolojik olarak incelendi. Ratlardan alınan kan örneklerinden aspartate aminotransferaz (AST), alanine aminotransferaz (ALT), alkalin fosfatase (ALP), laktat dehidrogenaz (LDH), total bilirubin, direk Bilirubin ve C-reaktif protein (CRP) çalışıldı. Bulgular. Birincigrupta 1 hayvanda bakteriyel translokasyon gözlenirken, II. grup...

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The Pathophysiology of Biliary Obstruction and Its Effect on Phagocytic and Immune Function

Cited by 146 publications

References 0 publications

Kupffer cell-derived interleukin 10 is responsible for impaired bacterial clearance in bile duct-ligated mice

Kupffer cell-derived interleukin 10 is responsible for impaired bacterial clearance in bile duct-ligated mice

Comparative study between ligature with thread or metallic clamping by means of laparoscopy with the purpose of experimental biliary obstruction in swines

Effect of beta-glucan in preventing bacterial translocation in a model of experimental obstructive jaundice

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