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Immune dysfunction in patients with obstructive jaundice before and after endoscopic retrograde cholangiopancreatography

Chowdhury, Abeed H.; Camara, Miguel; Martinez-Pomares, Luisa; Zaitoun, Abed M.; Eremin, Oleg; Aithal, Guruprasad P.; Lobo, Dileep

Authors

Abeed H. Chowdhury

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MIGUEL CAMARA MIGUEL.CAMARA@NOTTINGHAM.AC.UK
Professor of Molecular Microbiology

Abed M. Zaitoun

Oleg Eremin

DILEEP LOBO dileep.lobo@nottingham.ac.uk
Professor of Gastrointestinal Surgery



Abstract

© 2016 The Author(s). This prospective observational study investigated monocyte cytokine responses to lipopolysaccharide (LPS) in patients with obstructive jaundice (OJ) before and after endoscopic biliary drainage. Dendritic cell (DC) subsets and their expression of co-stimulatory molecules were also studied. Forty patients with OJ and ten non-jaundiced patients with normal gastroscopy findings were recruited. Ten healthy volunteers provided control blood samples for immunological assays. Patients with OJ had blood and duodenal mucosa sampled at the time of endoscopic retrograde cholangiopancreatography (ERCP) and further blood sampled during the recovery phase. Monocyte cytokine responses to LPS, DC subsets and co-stimulatory molecule expression were compared with controls. Duodenal morphology and occludin expression were also assessed. Monocytes obtained before ERCP from jaundiced patients demonstrated reduced cytokine responses to endotoxin compared with controls (IL-1β: 2678 compared with 4631 pg/ml, P= 0.04 and IL-6: 3442 compared with 6157 pg/ml, P= 0.002). Monocytes from patients with malignancy had poorer responses to endotoxin than from those with benign OJ (IL-1β: 2025 compared with 3332 pg/ml, P= 0.001). After ERCP, the secretion of inflammatory cytokines by monocytes obtained from jaundiced patients increased (IL-1β: 2150 compared with 2520 pg/ml, P= 0.03 and IL-6: 2488 compared with 3250 pg/ml, P= 0.01). Occludin expression (85 compared with 95%, P= 0.004) and mean duodenal villus height (334 compared with 404 μm, P= 0.03) were lower in jaundiced patients. Before biliary drainage, patients with OJ had a higher percentage of myeloid dendritic cells (mDCs) and greater mDC expression of CD40 (P= 0.04) and CD86 (P= 0.04). Monocytes from patients with OJ had lower proinflammatory cytokine secretion in response to LPS, an effect reversed following biliary drainage.

Citation

Chowdhury, A. H., Camara, M., Martinez-Pomares, L., Zaitoun, A. M., Eremin, O., Aithal, G. P., & Lobo, D. (2016). Immune dysfunction in patients with obstructive jaundice before and after endoscopic retrograde cholangiopancreatography. Clinical Science, 130(17), 1535-1544. https://doi.org/10.1042/CS20160326

Journal Article Type Article
Acceptance Date Jul 1, 2016
Online Publication Date Jul 18, 2016
Publication Date Jul 18, 2016
Deposit Date Feb 14, 2018
Publicly Available Date Mar 29, 2024
Journal Clinical Science
Print ISSN 0143-5221
Electronic ISSN 1470-8736
Publisher Portland Press
Peer Reviewed Peer Reviewed
Volume 130
Issue 17
Pages 1535-1544
DOI https://doi.org/10.1042/CS20160326
Keywords General Medicine
Public URL https://www.scopus.com/inward/record.uri?eid=2-s2.0-85014310974&doi=10.1042%2fCS20160326&partnerID=40&md5=71b4862ae4d5cd84cadeba14fe474bb3
Publisher URL http://www.clinsci.org/content/130/17/1535

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