THE SERUM LEVELS OF SOLUBLE INTERLEUKIN-2 RECEPTOR LEVELS IN PATIENTSWITH OBSTRUCTIVE-JAUNDICE

Background/Aims: Increased susceptibility to infection in, patients wi th obstructive jaundice is well recognized. Depression of reticuloendo thlial system phagocytic function and suppression of cellular immunity suggested by in vivo studies have been postulated as the cause. It ha s been. shown that increased serum soluble interleukin-2 receptor (sIL -2R) levels are the marker of immune system activation, especially T c ell activation. The purpose of this study was to evaluate cellular imm une system activation by measuring serum sIL-2R Levels in. 18 patients with obstructive jaundice (11 with choledocholithiasis, 7 with malign ant obstructive jaundice), 10 patients with liver cirrhosis and 10 hea lthy subjects. Material and Methods: Serum sIL-2R levels were measured by using ELISA(Boehringer Manheim). Lymphocyte subgroups were determi ned by flow-cytometry. Serum immungolubulins (IgG, IgA, IgM) and autoa ntibodies such as antinuclear antibody, rheumatoid factor, anti-thyrog lobulin and anti-microsomal antibody were measured. Results: The level s of-serum sIL-2R were found to be 47.1-121.2 (mean 77.3, SD+/-20.1) p mol/l in healthy subjects, 82.8-199.2 (mean 150.9+/-32.2) pmol/L in pa tients with liver cirrhosis and 32.6-172.5 (mean. 121.7 +/- 40.6 pmol/ L in patients with obstructive jaundice. Serum sIL-2R levels were sign ificantly higher in patients with liver cirrhosis or obstructive jaund ice than in. healthy subjects (p<0.01 and p<0.05 respectively). There is a significant difference in levels between patients with choledocho lithiasis and with malignant obstructive jaundice (p<0.01). Serum sIL- 2R levels were measured higher in. patients with liver cirrhosis than those in, patients with obstructive jaundice (p<0.059). Conclusions: I n patients with obstructive jaundice, and to a lesser extent in. those with liver cirrhosis, in vivo activation of immune system may be cons idered possible.