Bile and circulating HMGB1 contributes to systemic inflammation in obstructive jaundice

Area of Science:

• Gastroenterology
• Immunology
• Hepatology

Background:

• Obstructive jaundice (OJ) patients with cholangitis are susceptible to sepsis.
• The precise mechanisms underlying sepsis development in OJ remain unclear.

Purpose of the Study:

• To elucidate the mechanisms linking obstructive jaundice to sepsis and multiple organ dysfunction.

Main Methods:

• Systematic analysis of published data relevant to obstructive jaundice, cholangitis, and sepsis.

Main Results:

• Obstructive jaundice leads to bile acid accumulation and loss of gut luminal bile, causing bacterial overgrowth and translocation.
• This bacterial translocation triggers systemic inflammation and multiple organ dysfunction.
• High mobility group box 1 (HMGB1) in bile may promote gut barrier injury and bacterial translocation, contributing to organ damage.

Conclusions:

• HMGB1 may significantly contribute to systemic inflammation and multiple organ dysfunction in obstructive jaundice.
• Understanding these mechanisms is crucial for managing OJ patients with cholangitis.