S M Sheen-Chen1, H L Eng, F F Chou, W J Chen. 1. Department of Surgery, Pathology, and Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung, Chang Gung Medical College, Taiwan.
Abstract
BACKGROUND/AIMS: Hepatolithiasis is prevalent in Southeast Asia and remains a difficult problem to manage. Recent studies in immunology have provided evidence for the provocative roles of cytokines in many diseases. This study was designed to explore the possible relationship between the serum-soluble interleukin-2 receptor and the pathogenesis of hepatolithiasis. METHODOLOGY: In this pilot study, 34 patients with hepatolithiasis were included. All of the patients met the following criteria: (1) presence of hepatolithiasis; (2) no obvious clinical evidence of associated intrahepatic cholangiocarcinoma; (3) no clinical manifestation of cholangitis for at least 72 hours; (4) no intake of immunomodulatory agents in the previous 3 weeks; and (5) no blood transfusions in the previous 3 weeks. Venous blood samples were collected before surgery, and the concentrations of serum soluble interleukin-2 receptor were measured with an enzyme immunoassay method. Fifteen healthy subjects were used as the control group. Bile specimens routinely obtained during surgery were cultured for aerobes and anaerobes. The cholangiography films were reviewed in detail. RESULTS: The mean value of soluble interleukin-2 receptor in patients with hepatolithiasis was 706 +/- 294 units/ml, and that of the control group was 326 +/- 62 units/ml. The difference was significant (p < 0.01). Bacteria were present in the bile of all patients. The total number of bacterial species in the 34 patients was 119, and there was an average of 3.5 bacterial species cultured per patient. Intrahepatic bile duct strictures were present in 30 patients (88%). CONCLUSIONS: In addition to a high incidence of intrahepatic bile duct strictures and bacterial infection of the bile, significantly high levels of the serum soluble interleukin-2 receptor were also found in the patients with hepatolithiasis. The preliminary results in the present study seem to be promising, and the specific role of the soluble interleukin-2 receptor in patients with hepatolithiasis deserves further investigation and elucidation.
BACKGROUND/AIMS: Hepatolithiasis is prevalent in Southeast Asia and remains a difficult problem to manage. Recent studies in immunology have provided evidence for the provocative roles of cytokines in many diseases. This study was designed to explore the possible relationship between the serum-soluble interleukin-2 receptor and the pathogenesis of hepatolithiasis. METHODOLOGY: In this pilot study, 34 patients with hepatolithiasis were included. All of the patients met the following criteria: (1) presence of hepatolithiasis; (2) no obvious clinical evidence of associated intrahepatic cholangiocarcinoma; (3) no clinical manifestation of cholangitis for at least 72 hours; (4) no intake of immunomodulatory agents in the previous 3 weeks; and (5) no blood transfusions in the previous 3 weeks. Venous blood samples were collected before surgery, and the concentrations of serum soluble interleukin-2 receptor were measured with an enzyme immunoassay method. Fifteen healthy subjects were used as the control group. Bile specimens routinely obtained during surgery were cultured for aerobes and anaerobes. The cholangiography films were reviewed in detail. RESULTS: The mean value of soluble interleukin-2 receptor in patients with hepatolithiasis was 706 +/- 294 units/ml, and that of the control group was 326 +/- 62 units/ml. The difference was significant (p < 0.01). Bacteria were present in the bile of all patients. The total number of bacterial species in the 34 patients was 119, and there was an average of 3.5 bacterial species cultured per patient. Intrahepatic bile duct strictures were present in 30 patients (88%). CONCLUSIONS: In addition to a high incidence of intrahepatic bile duct strictures and bacterial infection of the bile, significantly high levels of the serum soluble interleukin-2 receptor were also found in the patients with hepatolithiasis. The preliminary results in the present study seem to be promising, and the specific role of the soluble interleukin-2 receptor in patients with hepatolithiasis deserves further investigation and elucidation.