Rege N N, Nazareth H M, Bapat R D, Dahanukar S A
Indian J Med Res. 1989 Dec;90:478-83.
A clinical study was undertaken to determine the immune status of patients with obstructive jaundice. Screening of 16 patients for phagocytic and microbicidal activity of polymorphonuclear cells (PMN) revealed a significant depression (21.2 +/- 3.7% phagocytosis and 20.85 +/- 4.5% intracellular killing) of these functions, as compared to normal values (30.37 +/- 5.1% and 26.41 +/- 4.3% respectively). An animal model of cholestasis was also established, using rats, in which a significant depression of activity of PMN and peritoneal macrophages was observed. These cellular abnormalities were found to precede and predispose to infection. The rats also showed an increased susceptibility to Escherichia coli infection (mortality rate 77.78%). A defect was detected in their serum responsible for depressing the function of phagocytic cells. An attempt was made to improve this immunosuppression by treating the rats with water extract of T. cordifolia 100 mg/kg for 7 days, following development of cholestasis. The extract improved the cellular immune functions. Mortality rate following Esch. coli infection was significantly reduced to 16.67 per cent. This study showed that cholestasis results in immunosuppression and therefore indicates the need for an immunomodulator in management of obstructive jaundice. The plant T. cordifolia seems to meet this need by consolidating host defence mechanism.
开展了一项临床研究以确定梗阻性黄疸患者的免疫状态。对16例患者的多形核细胞（PMN）的吞噬和杀菌活性进行筛查，结果显示这些功能显著降低（吞噬率为21.2±3.7%，细胞内杀菌率为20.85±4.5%），与正常值（分别为30.37±5.1%和26.41±4.3%）相比。还利用大鼠建立了胆汁淤积动物模型，观察到PMN和腹腔巨噬细胞的活性显著降低。发现这些细胞异常先于感染并易引发感染。大鼠对大肠杆菌感染的易感性也增加（死亡率为77.78%）。检测到其血清中存在一种缺陷，可抑制吞噬细胞的功能。在胆汁淤积形成后，尝试用100mg/kg的匙叶甘松水提取物对大鼠进行治疗7天，以改善这种免疫抑制。该提取物改善了细胞免疫功能。大肠杆菌感染后的死亡率显著降低至16.67%。这项研究表明，胆汁淤积会导致免疫抑制，因此表明在梗阻性黄疸的治疗中需要一种免疫调节剂。匙叶甘松似乎通过巩固宿主防御机制满足了这一需求。
