Impaired Kupffer cell function and effect of immunotherapy in obstructive jaundice.
BACKGROUND
Obstructive jaundice is frequently associated with septic complications. This study examined the influence of biliary obstruction on bacterial clearance and translocation. The study focused on the phagocytic and killing activities of Kupffer cells and the preventive effect on bacterial translocation of OK-432, which is a hemolytic streptococcal preparation developed as a biological response modifier.


METHODS
To study the mechanism of sepsis in obstructive jaundice, two groups of Wistar rats were examined: rats subjected to common bile duct ligation (CBDL) and rats subjected to a sham operation. Bacterial clearance, organ distribution, hepatic blood flow, and phagocytic function of Kupffer cells were examined. To evaluate the effect of OK-432 on bacterial translocation, rats were divided into three groups: sham operation + phosphate-buffered saline (PBS), CBDL + PBS, and CBDL + OK-432.


RESULTS
In this study, clearance of Escherichia coli. from the peripheral blood in CBDL rats was decreased significantly compared with that in sham-operated rats. Significant decreases in E.coli trapped in the liver and in hepatic blood flow were observed in CBDL rats compared with sham-operated rats. Phagocytic activity and superoxide production of Kupffer cells isolated from CBDL rats were significantly lower than in sham-operated rats. The incidence of bacterial translocation in CBDL rats was increased significantly, and oral administration of OK-432 prevented it.


CONCLUSIONS
The results suggest that susceptibility to infection in obstructive jaundice is due to impaired phagocytic function of Kupffer cells. Furthermore, obstructive jaundice promotes bacterial translocation, and OK-432 may be useful in preventing this translocation.
Tomioka
M
M
Second Department of Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-0003, Japan.
Iinuma
H
H
Okinaga
K
K
D000818:Animals; D018988:Bacterial Translocation; D002779:Cholestasis / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D003135:Common Bile Duct; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000150:complications / Q000503:physiopathology*; D007167:Immunotherapy; D007728:Kupffer Cells / Q000502:physiology*; D008099:Liver / Q000382:microbiology; D008111:Liver Function Tests; D008168:Lung / Q000382:microbiology; D008297:Male; D010844:Picibanil / Q000627:therapeutic use*; D051381:Rats; D017208:Rats, Wistar; D013154:Spleen / Q000382:microbiology
D010844:Picibanil