T-lymphocyte transformation in experimental obstructive jaundice: the role of serum-suppressive factors.

Infective complications are a significant problem in the management of patients with obstructive jaundice, despite the widespread use of prophylactic antibiotics. The cause of this may be suppression of the immune system. This study investigates the effect of serum from an animal model of extrahepatic biliary obstruction (BDL) for 7, 14, and 21 days on the lymphoproliferative response of a single population of T-lymphocytes to the mitogen phytohemagglutinin (PHA). Mean stimulation counts for lymphocytes cultured with 7 days with BDL serum (938 +/- 90 p = 0.04) and for 21 days with BDL serum (844 +/- 253 p = 0.04) are significantly lower than control serum (2382 +/- 1340). The effect of 14 days BDL serum has some suppression of lymphocyte stimulation but this is not significant (1115 +/- 429 p = 0.06). There was no significant correlation with any clinical parameters including bilirubin and the duration of jaundice. We have concluded that serum from animals with obstructive jaundice is immunosuppressive, but further studies are required to identify the factor and its role in vivo.