Obstructive jaundice in rats results in exaggerated hepatic production of tumor necrosis factor-alpha and systemic and tissue tumor necrosis factor-alpha levels after endotoxin.

Abstract

BACKGROUND:

Obstructive jaundice (OJ) predisposes patients to postoperative sepsis. We determined whether OJ led to an increased endotoxin stimulated tumor necrosis factor-alpha (TNF-alpha) production by macrophage-rich organs and whether a lack of intraluminal gut bile contributed to this increased sensitivity.

METHODS:

Rats underwent laparotomy and common bile duct ligation and division (CBDL) or sham operation after they were given low-dose endotoxin or saline solution (NS). TNF-alpha levels in plasma, perfusate from the isolated perfused rat liver, and tissue from lung, spleen, and liver were measured 90 minutes later. An additional group underwent creation of a choledochal-vesical fistula and endotoxin administration.

RESULTS:

The plasma TNF-alpha, liver perfusate TNF-alpha, and the tissue TNF-alpha levels in liver, lung, and spleen were significantly elevated in the CBDL + endotoxin (CBDL + ETX) group compared with the SHAM + ETX and CBDL + NS groups (p < 0.05). The choledochal-vesical fistula group after endotoxin had plasma TNF-alpha levels only 27% that of the CBDL + ETX group (p < 0.05).

CONCLUSIONS:

OJ sensitizes macrophage-rich organs to produce larger amounts of TNF-alpha in response to endotoxin. This sensitization is not solely due to decreased intraluminal gut bile.

• Authors: S O'Neil, J Hunt, J Filkins, R Gamelli
• Journal: Surgery (Surgery) Vol. 122 Issue 2 Pg. 281-6; discussion 286-7 (Aug 1997) ISSN: 0039-6060 [Print] United States
• PMID: 9288133 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Endotoxins
• Tumor Necrosis Factor-alpha
• Bilirubin

Topics

• Animals
• Bilirubin (blood)
• Cholestasis (blood, immunology, physiopathology)
• Common Bile Duct (physiology)
• Common Bile Duct Diseases
• Endotoxins (pharmacology)
• Fistula
• In Vitro Techniques
• Liver (drug effects, immunology, physiopathology)
• Lung (immunology, physiopathology)
• Male
• Perfusion
• Rats
• Rats, Sprague-Dawley
• Reference Values
• Salmonella enteritidis
• Spleen (immunology, physiopathology)
• Time Factors
• Tumor Necrosis Factor-alpha (biosynthesis)
• Urinary Bladder Diseases