Neutrophil priming by cytokines in patients with obstructive jaundice

Patients with obstructive jaundice frequently suffer postoperative complications. We have investigated the relationship of obstructive jaundice to the neutrophil oxidase response and the "priming" of the response by the cytokines TNF alpha, interleukin-1 (IL-1), IL-6, and IL-8. On stimulation with f-met-leu-phe (fmlp), the respiratory burst in neutrophils from jaundiced patients was greatly increased compared with controls (p < 0.01), jaundiced patients having the highest respiratory burst levels were those with the poorest prognosis. Neutrophils from controls were primed by all the cytokines tested, whereas "jaundiced" cells were primed only by IL-1, and not by TNF alpha, IL-6, or IL-8, which in fact produced slight inhibition. We conclude that neutrophils from obstructive jaundiced patients have raised oxidative responses which may be due to "pre-priming" in vivo by cytokines, such as IL-6, IL-8, or TNF alpha. This exaggeration of the oxidative response in circulating neutrophils may contribute to the peri-operate complications of patients with obstructive jaundice.