Ball S K, Grogan J B, Collier B J, Scott-Conner C E
Department of Surgery, University of Mississippi School of Medicine, Jackson.
Am Surg. 1991 Feb;57(2):67-72.
Reticuloendothelial system dysfunction has been suggested as an explanation for the increased susceptibility to infection in patients with obstructive jaundice. In the present study, the response of cholestatic rats to a bacterial challenge was investigated and the uptake of bacteria by their Kupffer cells was examined with the electron microscope. Rats underwent bile duct ligation (BDL, n = 8) of sham celiotomy (SC, n = 8) and were allowed to recover for 10 days. They were then injected with 10(9) Staphylococcus aureus IV and killed at intervals of 15, 30, 60, and 180 minutes after injection. Two from each group were killed at each interval. Quantitative blood cultures were performed, and specimens of liver and lung were obtained for quantitative bacterial culture and processed for electron microscopy. Bacteria were rapidly cleared from the bloodstream of SC animals but persisted in BDL rats. Electron microscopy consistently demonstrated bacteria within Kupffer cell phagocytic vesicles of both SC and BDL animals at each interval selected. There was no morphologic difference in these vesicles between the two groups. Bacteremia persists in BDL rats subjected to a bacterial challenge despite rapid uptake of bacteria in apparently normal phagocytic vesicles. This study suggests a defect in intracellular killing of bacteria, an impairment of delivery of bacteria to RE cells, or a combination of these factors.
网状内皮系统功能障碍被认为是阻塞性黄疸患者易感染的一种解释。在本研究中，对胆汁淤积大鼠对细菌攻击的反应进行了研究，并用电子显微镜检查了其库普弗细胞对细菌的摄取。大鼠接受胆管结扎（BDL，n = 8）或假剖腹术（SC，n = 8），并使其恢复10天。然后给它们注射10⁹金黄色葡萄球菌IV，并在注射后15、30、60和180分钟的间隔处死。每个间隔从每组中处死2只。进行定量血培养，并获取肝脏和肺的标本进行定量细菌培养，并进行电子显微镜处理。细菌在SC动物的血液中迅速清除，但在BDL大鼠中持续存在。电子显微镜始终显示在所选的每个间隔，SC和BDL动物的库普弗细胞吞噬小泡内都有细菌。两组之间这些小泡在形态上没有差异。尽管细菌在明显正常的吞噬小泡中被迅速摄取，但BDL大鼠在受到细菌攻击后仍存在菌血症。本研究提示存在细胞内细菌杀伤缺陷、细菌向网状内皮细胞递送受损或这些因素的组合。
