Impaired Kupffer cell function and effect of immunotherapy in obstructive jaundice

Background. Obstructive jaundice is frequently associated with septic compl ications. This study examined the influence of biliary obstruction on bacte rial clearance and translocation. The study focused on the phagocytic and k illing activities of Kupffer cells and the preventive effect on bacterial t ranslocation of OK-432, which is a hemolytic streptococcal preparation deve loped as a biological response modifier. Methods. To study the mechanism of sepsis in obstructive jaundice, two grou ps of Wistar rats were examined: rats subjected to common bile duct ligatio n (CBDL) and rats subjected to a sham operation. Bacterial clearance, organ distribution, hepatic blood how, and phagocytic function of Kupffer cells were examined. To evaluate the effect of OK-432 on bacterial translocation, rats were divided into three groups: sham operation + phosphate-buffered s aline (PBS), CBDL + PBS, and CBDL + OK-432. Results. In this study, clearance of Escherichia coli. from the peripheral blood in CBDL rats was decreased significantly compared with that in sham-o perated rats. Significant decreases in E. coli trapped in the liver and in hepatic blood how were observed in CBDL rats compared with sham-operated ra ts. Phagocytic activity and superoxide production of Kupffer cells isolated from CBDL rats were significantly lower than in sham-operated rats. The in cidence of bacterial translocation in CBDL rats was increased significantly , and oral administration of OK-432 prevented it. Conclusion. The results suggest that susceptibility to infection in obstruc tive jaundice is due to impaired phagocytic function of Kupffer cells. Furt hermore, obstructive jaundice promotes bacterial translocation, and OK-432 may be useful in preventing this translocation. (C) 2000 Academic Press.