Ascending cholangitis provokes IL-8 and MCP-1 expression and promotes inflammatory cell infiltration in the cholestatic rat liver

Background/Purpose: Postoperative cholangitis is one of the most common com plications after bile duct reconstruction. The pathogenesis and early conse quences of ascending cholangitis still are unidentified. Methods. Male Sprague-Dawley rats were divided into 5 treatment groups: con trol (n = 4), blood sampling and liver biopsy only; group I, [BDL/Escherich a coli, n = 6], ligation of common bile duct (BDL) for a week, followed by Roux-en-Y choledochojejunostomy (RYCJ) and injection of E coli(ATCC 25922) into Roux limb after 24 hours; group II, [BDL/NS; n = 5], same procedures a s in group I, with injection of normal saline (NS) into Roux limb; group II I, [SBDL/E coli, n = 6], primary RYCJ was constructed 1 week after sham lig ation of common bile duct (SBDL) followed by the same treatment as group 1; Group IV, [SBDL/N.S; n = 6], same procedures as in group III, but injectin g NS into Roux limb. All animals were killed after 24 hours of treatment. B lood was sampled for culture and serum cytokine levels. The liver was harve sted for quantitative bacteria[ culture, as well as for MCP-1, interleukin (IL)-8 (CINC in the rat) and transforming growth factor beta1 mRNA expressi on by reverse transcriptase polymerase chain reaction (RT-PCR) and for immu nohistochemistry. The choledochojejunostomy was resected for culture. Serum cytokine levels were detected by ELISA kits. Results: A significant increase of E coli ATCC 25922, occurred in the liver s of group I rats, compared with group IV (P =.037). MCP-1 expression incre ased in all groups, compared with control (P =.000). The IL-8 mRNA expressi on was significantly higher in group I than in control (P =.021). The expre ssion of TGF-beta1 mRNA was similar among the groups (P =.361), consistent with the immunohistochemistry results, The serum MCP-1 and IL-8 levels were higher in the 4 groups than in the control (P =.000) and were significantl y higher in group I than in group IV (P=.001). Conclusions: This study found that a significant colonization of E coli of the same strain was present in the cholestatic rat liver injected into the Roux limb, which was associated with a higher expression of liver MCP-1 and IL-8 mRNA, a significant increase of serum MCP-1 and IL-8, and a more evid ent inflammatory cell infiltration into the porta hepatis. J Pediatr Surg 3 6:1623-1628. Copyright (C) 2001 by W.B. Saunders Company.