El-Sayed Ibrahim H, El kady Ibrahim M, Badra Gamal A
Molecular Biology Department, Genetic Engineering and Biotechnology Institute, Menofiya University, Sadat City, P.O. Box 22857-79, Egypt.
Clin Chim Acta. 2003 Oct;336(1-2):123-8. doi: 10.1016/s0009-8981(03)00336-x.
Obstructive jaundice is an important clinical problem. It may cause transient hemolysis and shortened erythrocyte life span as well as cytokine induction. An increase in lipid peroxidation has been noted as evidence of oxidative damage in red cells due to cholestasis. The influence of endoscopic retrograde cholangiopancreatography (ERCP), mechanical lithotrepsy and stone extraction on the antioxidative capacity of the erythrocyte and immune response is still unclear.
Superoxide dismutase (SOD), catalase (CAT) and glutathione (GSH) content of red blood cells (RBC), and serum interleukin (IL-18) were measured in 20 patients with calcular obstructive jaundice before and 4 weeks after ERCP intervention and compared with 10 matched healthy volunteers.
A significant decrease (p<0.05) in SOD and CAT activities and glutathione concentration but a significant increase (p<0.05) in serum IL-18 were observed in cholestatic patients compared with the healthy control and were significantly correlated with variable of hepatic dysfunction (alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, alkaline phosphatase (ALP) and gamma glutamyl transferase (GGT). After ERCP, serum IL-18 and antioxidant capacity of red blood cells were significantly improved and returned to normal concentration (p<0.05).
In biliary obstruction, serum IL-18 is increased and antioxidative capacity is decreased, and have a direct correlation with biochemical markers of liver injury. After ERCP intervention, the altered antioxidative capacity as well as serum IL-18 was completely restored to normal.
梗阻性黄疸是一个重要的临床问题。它可能导致短暂性溶血、红细胞寿命缩短以及细胞因子诱导。脂质过氧化增加已被视为胆汁淤积导致红细胞氧化损伤的证据。内镜逆行胰胆管造影术（ERCP）、机械碎石术和结石取出术对红细胞抗氧化能力和免疫反应的影响仍不清楚。
对20例结石性梗阻性黄疸患者在ERCP干预前及干预后4周测量红细胞（RBC）中的超氧化物歧化酶（SOD）、过氧化氢酶（CAT）和谷胱甘肽（GSH）含量，以及血清白细胞介素（IL-18），并与10名匹配的健康志愿者进行比较。
与健康对照组相比，胆汁淤积患者的SOD和CAT活性以及谷胱甘肽浓度显著降低（p<0.05），但血清IL-18显著升高（p<0.05），且与肝功能异常指标（丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素、碱性磷酸酶（ALP）和γ-谷氨酰转移酶（GGT））显著相关。ERCP术后，血清IL-18和红细胞抗氧化能力显著改善并恢复至正常浓度（p<0.05）。
在胆道梗阻中，血清IL-18升高，抗氧化能力降低，且与肝损伤生化指标直接相关。ERCP干预后，改变的抗氧化能力以及血清IL-18完全恢复正常。
