Treglia-Dal Lago Marisa, Jukemura Jose, Machado Marcel Cerqueira Cesar, da Cunha Jose Eduardo Monteiro, Barbuto Jose Alexandre Marzagão
Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
Pancreatology. 2006;6(4):273-8. doi: 10.1159/000092688. Epub 2006 Apr 19.
The immune function is altered in jaundiced patients; here, the ability of their peripheral blood mononuclear cells to perform phagocytosis and to release H2O2 was analyzed.
Cells from 53 patients before surgery for relief of cholestasis, from 38 patients 1 week and from 15 patients 2 weeks after surgery were separated and cultured for 1 h in the presence of phorbol myristate acetate. H2O2 release was evaluated colorimetrically and phagocytosis by the ingestion of Escherichia coli in vitro.
Before surgery for relief of cholestasis, the cells of the patients were unable to release H2O2, but, after surgery, an increasing percentage of patients had cells that were able to produce H2O2 (13% after 1 week; 33% after 2 weeks). This recovery did not correlate with bilirubinemia. When cultured for 1 week in the presence of normal or jaundiced plasma, regardless of collection time, cells of 12/12 patients released H2O2, but in lower levels if in the presence of jaundiced plasma. In contrast, H2O2 release by normal donor cells was enhanced in the presence of jaundiced plasma. Phagocytosis by cells of the patients was lower, but when present was associated with a significantly higher bactericidal activity.
These significant, but reversible alterations of monocyte function in jaundiced patients might contribute to their enhanced susceptibility to surgical complications.
黄疸患者的免疫功能会发生改变；在此，对其外周血单核细胞进行吞噬作用和释放过氧化氢能力进行了分析。
分离53例术前用于缓解胆汁淤积的患者、38例术后1周患者以及15例术后2周患者的细胞，在佛波酯存在的情况下培养1小时。通过比色法评估过氧化氢的释放，并通过体外摄取大肠杆菌来评估吞噬作用。
在用于缓解胆汁淤积的手术前，患者的细胞无法释放过氧化氢，但术后，能够产生过氧化氢的患者比例不断增加（1周后为13%；2周后为33%）。这种恢复与胆红素血症无关。在正常或黄疸血浆存在的情况下培养1周，无论采集时间如何，12/12例患者的细胞均释放过氧化氢，但在黄疸血浆存在时水平较低。相比之下，在黄疸血浆存在的情况下，正常供体细胞的过氧化氢释放增强。患者细胞的吞噬作用较低，但存在时杀菌活性显著更高。
黄疸患者单核细胞功能的这些显著但可逆的改变可能导致其手术并发症易感性增加。
