PRETREATMENT WITH ENTERAL CHOLESTYRAMINE PREVENTS SUPPRESSION OF THE CELLULAR IMMUNE-SYSTEM AFTER PARTIAL-HEPATECTOMY

Citation
Pam. Vanleeuwen et al., PRETREATMENT WITH ENTERAL CHOLESTYRAMINE PREVENTS SUPPRESSION OF THE CELLULAR IMMUNE-SYSTEM AFTER PARTIAL-HEPATECTOMY, Annals of surgery, 221(3), 1995, pp. 282-290
Citations number
53
Categorie Soggetti
Surgery
Journal title
ISSN journal
00034932
Volume
221
Issue
3
Year of publication
1995
Pages
282 - 290
Database
ISI
SICI code
0003-4932(1995)221:3<282:PWECPS>2.0.ZU;2-U
Abstract
Objective The authors tested the hypothesis that the beneficial effect s of the endotoxin-binding agent cholestyramine on the postoperative c ourse in rats that had undergone a partial hepatectomy was the result of improvement of cellular immune functions. Summary Background Data M ajor liver resection is associated with severe postoperative complicat ions and a high incidence oi systemic infections. Gut-derived endotoxi ns previously were shown to be involved in the pathogenic processes af ter partial hepatectomy in rats. In addition, enteral cholestyramine i mproved postoperative survival, but how its beneficial effects are med iated is not clear. Methods Rats that were force-fed for 7 days with e ither cholestyramine (150 mg/day) or 0.9% saline (equal volume) were r andomized to undergo a partial hepatectomy or a sham operation. After 24 hours, the rats were killed and splenic mononuclear cells were test ed in vitro for mitogenic responses and cytokine production.Results Pr oliferative responses of splenic B and T lymphocytes and lipopolysacch aride-stimulated production of tumor necrosis factor and interleukin-1 by splenocytes were lower in rats after partial hepatectomy than in s ham-operated animals. An increased concanavalin A-stimulated productio n of interleukin-2 also was found after partial hepatectomy compared w ith sham levels. Pretreatment with enteral cholestyramine preserved ce llular proliferative responsiveness of both B and T cells, and restore d cytokine production by splenocytes to sham levels. Conclusion Prophy lactic treatment with enteral cholestyramine preserved cellular immune functions after partial hepatectomy in the rat, which may explain its beneficial effects on the postoperative course. Furthermore, the auth ors' results are consistent with the hypothesis that endotoxemia is in volved in the pathogenesis of the cellular immune derangements after p artial hepatectomy.