title: Biliary obstruction reduces hepatic killing and phagocytic clearance of circulating microorganisms in rats.
abstract: Septic complications are common in patients with biliary obstruction. This is thought to be related, in part, to dysfunction of the hepatic reticuloendothelial system (RES). It has been reported that nearly 80% of circulating microorganisms are phagocytosed and killed within the liver and that clearance of circulating pathogens is significantly impaired in patients with jaundice. However, the effect of biliary obstruction specifically on phagocytic killing within the liver is less well described. Therefore this study was designed to quantify the effect of biliary obstruction, simultaneously and discriminately, on two important components of hepatic RES function (phagocytosis and phagocytic killing). Rats were divided into three experimental groups: control, sham, and jaundiced (common bile duct ligation). At 7, 10, 14, and 21 days after operation, E. coli labeled with both 125I and 51Cr were injected intravenously. Using the previously validated double-labeled in vivo E. coli technique, hepatic phagocytic clearance (HPC), hepatic killing efficiency (HKE), and net hepatic killing (NHK) were measured. Common bile duct ligation resulted in a significant decrease in the HPC of E. coli 10, 14, and 21 days postoperatively. Similarly, HKE was significantly decreased in jaundiced animals by postoperative day 10, but returned to baseline values by day 14. The net effect of these changes in HPC and HKE values were reflected in a significant reduction in NHK in jaundiced animals. Results of the present study suggest that obstructive jaundice impairs both phagocytosis and phagocytic killing within the liver. These findings may help to explain the susceptibility of patients with biliary tract obstruction to the morbidity and mortality of septic complications.
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Sumito
authors.initials: S
authors.lastname: Hoshino
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Zhaoli
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Uchikura
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Kyoji
authors.initials: K
authors.lastname: Tsugane
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Eugene
authors.initials: E
authors.lastname: Ceppa
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Bulkley
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland. aklein@jhmi.edu.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Klein
mesh_terms: D000818:Animals; D002779:Cholestasis / Q000503:physiopathology*; D002860:Chromium Radioisotopes; D004926:Escherichia coli; D006801:Humans; D007065:Idoxuridine / Q000493:pharmacokinetics; D008099:Liver / Q000503:physiopathology*; D008168:Lung / Q000378:metabolism; D008297:Male; D012157:Mononuclear Phagocyte System / Q000503:physiopathology*; D010587:Phagocytosis / Q000502:physiology; D051381:Rats; D017207:Rats, Sprague-Dawley; D013154:Spleen / Q000378:metabolism; D014018:Tissue Distribution
chemical_list: D002860:Chromium Radioisotopes; D007065:Idoxuridine