Jv. Reynolds et al., FAILURE OF MACROPHAGE ACTIVATION IN EXPERIMENTAL OBSTRUCTIVE-JAUNDICE- ASSOCIATION WITH BACTERIAL TRANSLOCATION, British Journal of Surgery, 82(4), 1995, pp. 534-538
Bacterial translocation from the gastrointestinal tract and macrophage
activation are central to current theories of sepsis. The relevance o
f both in obstructive jaundice is unclear. The effect of bile duct lig
ation for 7 days on bacterial translocation to mesenteric lymph nodes
and on macrophage activation in a rat model was examined. Compared wit
h an incidence of zero in sham-ligated controls, bile-duct ligated rat
s had a 67 per cent incidence of Gram-negative colonization of mesente
ric lymph nodes. This was associated with a significant (P < 0.001) de
crease in macrophage tumour necrosis factor, superoxide anion and nitr
ic oxide production compared with that in sham controls. Spontaneous b
acterial translocation occurs in experimental obstructive jaundice and
is associated with marked suppression of macrophage activation. This
suggests a mechanism whereby jaundiced patients may be more susceptibl
e to persistent infection but relatively protected against uncontrolle
d sepsis.