Saba T M
Ann Surg. 1978 Aug;188(2):142-52. doi: 10.1097/00000658-197808000-00003.
Depression of the reticuloendothelial system (RES) was observed in rats following operative trauma consisting of laparotomy and jejunal enterotomy. This RES depression was manifested as a significant impairment in the phagocytic clearance of intravenously injected blood-borne test colloid mediated by a decline in hepatic Kupffer cell phagocytosis. Reticuloendothelial systemic host defense depression was correlated with a significant decline in bioassayable and immunoreactive opsonic alpha(2)SB glycoprotein concentration over a 1-3 hr postoperative period with rebound elevation in opsonic activity by 24 hr postsurgery. Intravenous administration of purified opsonic alpha(2)SB glycoprotein at the end of the operation prevented postoperative opsonic deficiency and restored normal hepatic RES phagocytic function. These studies coupled with previous observations in patients following surgery or after severe multiple trauma suggest that reticuloendothelial depression during and after operation mediated by opsonic deficiency may lead to a precarious imbalance between systemic host defense and the dissemination of blood-borne foreign and effete particulate matter such as injured platelets, fibrin microaggregates and immune complexes. Immunoreactive serum opsonic alpha(2)SB glycoprotein determinations may serve as a valuable index of hepatic RE clearance capacity and opsonin therapy may potentially be a selective means to augment systemic host defense.
在接受由剖腹术和空肠切开术组成的手术创伤后的大鼠中，观察到网状内皮系统（RES）受到抑制。这种RES抑制表现为肝库普弗细胞吞噬作用下降介导的静脉注射血源性测试胶体的吞噬清除功能显著受损。网状内皮系统宿主防御抑制与术后1 - 3小时内可生物测定的和免疫反应性调理素α(2)SB糖蛋白浓度显著下降相关，术后24小时调理活性出现反弹升高。在手术结束时静脉注射纯化的调理素α(2)SB糖蛋白可预防术后调理素缺乏，并恢复正常的肝RES吞噬功能。这些研究以及先前对手术患者或严重多发伤患者的观察表明，由调理素缺乏介导的手术期间和术后网状内皮抑制可能导致全身宿主防御与血源性异物和衰老颗粒物（如受损血小板、纤维蛋白微聚体和免疫复合物）传播之间的不稳定失衡。免疫反应性血清调理素α(2)SB糖蛋白测定可能是肝RE清除能力的有价值指标，调理素疗法可能是增强全身宿主防御的一种选择性手段。
