Mok K T, Wang B W, Chang H C, Lin S L
Department of Surgery, Veterans General Hospital-Kaohsiung, National Yang-Ming University, Taiwan.
Dig Dis Sci. 2001 Sep;46(9):1864-70. doi: 10.1023/a:1010670711664.
This study investigates the importance of intestinal bile flow in cellular immunity. Sprague-Dawley rats undergoing bile duct ligation (BDL) and sham ceiliotomy (Sham) for 14 and 21 days were investigated. Experimental animals following BDL were further divided into an external drainage (ED) group, an ED group with rat chow mixed with 2:2:1 cholic acid, chenodeoxycholic acid, and deoxycholic acid (ED + BF), and an internal drainage (ID) group. Fourteen days later, they were killed and analyzed for spleen lymphocytic [3H] thymidine uptake (LHU) under mitogen stimulation with phytohemagglutinin, blood biochemistry, hemogram, and liver pathology. In the 14-day BDL experiment, LHU and serum albumin level were decreased in the BDL group (P < 0.05). After drainage, they were not significantly different among sham, ED, ED + BF, and ID groups. In the 21-day BDL experiment, the red cell volume was decreased (P < 0.05). After drainage, the ED, ED + BF, and ID groups still had a significantly lower LHU than the sham group (P < 0.05). However, the ID group had higher LHU than the ED and ED + BF groups (P < 0.05). The ED + BF group had a slightly higher LHU than the ED group but not statistically significant. Liver pathology returned to normal after drainage in the 14-day BDL model. In contrast, the 21-day BDL group had prominent periportal necrosis and developed periportal fibrosis after drainage. The present study reveals the duration of BDL determines the severity of hepatic damage. In the 14-day BDL groups, all kinds of drainage completely reverse the impaired liver function and cellular immunity. In the 21-day BDL group, 14-day drainage is inadequate for recovery because irreversible pathological changes are found. The reversal of cellular immunity in ID is better and faster, because it provides a better hepatic functional, nutritional, and hematological recovery besides the presence of primarily secreted bile acids.
本研究调查了肠道胆汁流动在细胞免疫中的重要性。对接受胆管结扎（BDL）和假剖腹术（Sham）14天及21天的Sprague-Dawley大鼠进行了研究。BDL后的实验动物进一步分为外引流（ED）组、饲料中混合有胆酸、鹅去氧胆酸和脱氧胆酸比例为2:2:1的ED组（ED + BF）和内引流（ID）组。14天后，将它们处死，并在植物血凝素促有丝分裂刺激下分析脾淋巴细胞[³H]胸腺嘧啶核苷摄取（LHU）、血液生化、血常规和肝脏病理学。在14天BDL实验中，BDL组的LHU和血清白蛋白水平降低（P < 0.05）。引流后，假手术组、ED组、ED + BF组和ID组之间无显著差异。在21天BDL实验中，红细胞体积降低（P < 0.05）。引流后，ED组、ED + BF组和ID组的LHU仍显著低于假手术组（P < 0.05）。然而，ID组的LHU高于ED组和ED + BF组（P < 0.05）。ED + BF组的LHU略高于ED组，但无统计学意义。在14天BDL模型中，引流后肝脏病理学恢复正常。相比之下，21天BDL组有明显的门静脉周围坏死，引流后出现门静脉周围纤维化。本研究表明BDL的持续时间决定了肝损伤的严重程度。在14天BDL组中，各种引流完全逆转了受损的肝功能和细胞免疫。在21天BDL组中，14天的引流不足以恢复，因为发现了不可逆的病理变化。ID组中细胞免疫的逆转更好更快，因为除了存在主要分泌的胆汁酸外，它还能实现更好的肝功能、营养和血液学恢复。
