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Impaired immune function in obstructive jaundice.

D W Vane1, P Redlich, T Weber

  • 1Section of Pediatric Surgery, Transplantation, and Nuclear Medicine, Indiana University School of Medicine, Indianapolis.

The Journal of Surgical Research
|September 1, 1988
PubMed
Summary
This summary is machine-generated.

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Obstructive jaundice impairs both lymphocyte and reticuloendothelial system (RES) function, increasing sepsis susceptibility. These immune deficits recover after bile duct obstruction is relieved.

Area of Science:

  • Immunology
  • Gastroenterology
  • Surgical Complications

Background:

  • Sepsis is a severe complication of obstructive jaundice.
  • The underlying immunological mechanisms are not fully understood.

Purpose of the Study:

  • To investigate the impact of obstructive jaundice on lymphocyte and reticuloendothelial system (RES) function.
  • To assess the reversibility of these immune changes after relieving the obstruction.

Main Methods:

  • Lymphocyte function was assessed using phytohemagglutinin (PHA), concanavalin A (Con A), and pokeweed mitogen (PWM) stimulation in rabbits.
  • Hepatic RES function was evaluated by calculating the phagocytic index (PI) using 99Tc sulfacolloid clearance.
  • Biliary obstruction was surgically induced and later relieved via cholecystojejunostomy (CJ).

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Main Results:

  • Obstructive jaundice significantly impaired lymphocyte function, indicated by reduced stimulation indices (P < 0.006).
  • Hepatic RES function, measured by PI, decreased significantly (P < 0.01) with obstruction and remained low for 3 months post-reversal.
  • Lymphocyte function normalized after obstruction relief, and RES function returned to baseline levels by 6 months.

Conclusions:

  • Obstructive jaundice causes significant, reversible impairment of both cellular immunity and RES phagocytic capacity.
  • These immune dysfunctions likely contribute to the increased risk of sepsis in patients with obstructive jaundice.
  • Restoration of bile flow is crucial for immune system recovery.