FAILURE OF MACROPHAGE ACTIVATION IN EXPERIMENTAL OBSTRUCTIVE-JAUNDICE- ASSOCIATION WITH BACTERIAL TRANSLOCATION

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.