Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Imparied cell-mediated immunity has been described in obstructive jaundice and has been attributed to depressant serum factors or to depressed intrinsic T-cell function. The authors studied lymphocyte responsiveness to phytohemagglutinin stimulation, the in-vitro correlate of T-cell function, in 11 patients with biliary obstruction. Peripheral-blood mononuclear cells and serum were obtained before (mean serum bilirubin level 302 mumol/L) and after (mean serum bilirubin level 23 mumol/L) treatment of the biliary obstruction. Simultaneous cell culture of all samples disclosed no evidence of a serum depressant factor in patients with obstructive jaundice, and crossover incubation studies failed to suggest that there is a depression of intrinsic T-cell responsiveness that can be reversed by biliary drainage.
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PMID:Human lymphocyte responsiveness is not enhanced by relief of biliary obstruction: an in-vitro study. 202 1

Obstructive jaundice causes depression of immune system function but it is unclear at present how rapidly immune function recovers after relief of biliary obstruction. To address this issue, we studied 218 Sprague-Dawley rats with common bile duct obstruction. Mononuclear phagocyte function, cell mediated immune function, portal-systemic shunt fraction, liver function tests, and liver histology were evaluated in normal (sham) rats, obstructed rats, and at weekly intervals after relief of biliary obstruction. Hepatic uptake of radiolabelled bacteria was 82 per cent in sham rats and 66 per cent in rats 21 days after CBD obstruction (P less than 0.05). Phagocytic activity returned to normal within 7 days after choledochoduodenostomy. Cell mediated immunity, measured by skin graft rejection, was significantly prolonged in the obstructed group (P less than 0.05) but had returned to normal 7 days after biliary diversion. Return of hepatocellular function, as measured by liver function tests, paralleled recovery of immune function. This study demonstrates prompt recovery of the immune system after internal biliary drainage for obstructive jaundice. This finding is in contrast to previous studies that demonstrated persistent immune suppression months after biliary diversion. These data may have implications concerning the usefulness of internal biliary drainage before surgery in patients with obstructive jaundice.
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PMID:Effects of relief of biliary obstruction on mononuclear phagocyte system function and cell mediated immunity. 181 Feb 99

The increased susceptibility to infections after surgery in jaundiced patients is considered to be caused by an impairment of cellular immunity and/or nutritional status. Endotoxins are suggested to play a role in the pathogenesis. However, the mechanism of action is unknown. Germ-free rats were used to study the effect of biliary obstruction in a model with negligible amounts of endotoxin. Cellular immunity, production of tumor necrosis factor (as a mediator of endotoxin toxicity) by peritoneal macrophages, and the nutritional status were assessed. Significant suppression of cellular immunity was found in conventional rats with obstructive jaundice. In contrast, cellular immunity was not suppressed in jaundiced germ-free rats. Large amounts of tumor necrosis factor were spontaneously secreted by peritoneal macrophages of jaundiced conventional rats, whereas macrophages from jaundiced germ-free rats did not. Moreover macrophage activation (expressed in tumor necrosis factor production) was significantly related to suppression of cellular immunity. Weight changes and depression of albumin levels were not different in germ-free and conventional rats after bile duct ligation. The data presented indicate that suppression of cellular immunity in obstructive jaundice is caused by endotoxins, whereas the impaired nutritional status seems to not be affected by the presence of endotoxins.
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PMID:Suppression of cellular immunity in obstructive jaundice is caused by endotoxins: a study with germ-free rats. 229 4

Previous studies have demonstrated depression of the mononuclear phagocyte system (MPS) of which the liver comprises 80-85% in animals subjected to 21 days of obstructive jaundice. This study examined the ability of a macrophage stimulant, muramyl dipeptide (MDP), to reverse MPS dysfunction in an obstructive jaundice rat model. Sixty-two male Sprague-Dawley rats underwent sham (n = 29) laparotomy or common duct ligation (CDL) (n = 33) and were studied after 21 days. Animals were injected with 1-3.5 X 10(6) Escherichia coli via a lateral tail vein, and colony-forming units (CFU) of the liver, lung, and spleen were determined at two time intervals: 30 min postinjection to determine the phagocytic activity of MPS (sham, n = 16; CDL, n = 20) and 24 hr postinjection to determine cytotoxic activity of MPS (sham, n = 13; CDL, n = 13). MDP (3 micrograms/g) was administered subcutaneously 24 hr prior to E. coli injection in 6 sham and 10 CDL rats studied at the 30-min time interval and 7 sham and 7 CDL rats studied at the 24-hr time interval. Pretreatment with MDP appeared to reverse the impairment of phagocytic activity in the liver of CDL rats returning it to the level of sham animals (P less than 0.05). However, pretreatment with MDP did not enhance the cytotoxic activity of the MPS as evidenced by higher CFU of E. coli in the liver, lung, and spleen of CDL animals pretreated with MDP as compared to CDL animals that did not receive MDP pretreatment. This increase was only significant in the spleen.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Muramyl dipeptide improves mononuclear phagocyte system function in obstructive jaundice. 231 99

High surgical mortality in patients with obstructive jaundice and sepsis have been attributed to reticuloendothelial system (RES) depression. The purpose of this study was to clarify the effects of mechanical biliary obstruction on RES clearance of pathogenic bacteria by comparing the phagocytic index (K) with the directly measured hepatic uptake of indium 111-labeled bacteria injected into the portal vein of normal dogs and dogs with partial (PBO) or complete biliary obstruction (CBO). No significant difference was observed between the K in normal dogs (0.19 +/- 0.08; n = 6) and that in dogs with PBO (0.24 +/- 0.06; n = 5) or CBO (0.21 +/- 0.03; n = 4). There was no significant difference in uptake of radiolabel by the liver among the three groups of dogs. In our model, biliary obstruction had no effect on hepatic RES function and may not represent a significant determinant of mortality in patients with obstructive jaundice.
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PMID:Effects of biliary obstruction on hepatic clearance of bacteria. 250 73

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.
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PMID:Modulation of immunosuppression in obstructive jaundice by Tinospora cordifolia. 269 92

The mechanism of acute gastric ulceration in rats with obstructive jaundice was investigated in terms of the changes in the gastric mucosal energy metabolism. Rats were divided into 4 groups as follows: control, vagotomized, jaundiced, and jaundiced and vagotomized group. The water immersion and restraint procedures were performed and the ulcer index was calculated. The change of energy metabolism in the gastric mucosa of corpus and antrum was clarified by measuring ATP and energy charge. The following results were obtained: Vagotomized group showed significant decreased ulcer index, however, the gastric mucosal energy metabolism were unchanged compared to the control group after stress. Jaundiced group showed significant higher ulcer index, and the early, significant depression of the gastric mucosal energy metabolism compared to the control group. Jaundiced and vagotomized group showed significant improvement of ulcer index and gastric mucosal energy metabolism compared to the jaundiced group. The gastric energy metabolism of the corpus revealed more prominent depression than that of the antrum in jaundiced group, and jaundiced and vagotomized group. These data suggested that the deterioration of the gastric mucosal energy metabolism after stress was enhanced under the condition of obstructive jaundice and these results were improved by vagotomy.
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PMID:[Effect of obstructive jaundice on acute gastric ulceration viewed from gastric mucosal energy metabolism in rats]. 652 25

Processes of malignancy and hemostasis can in principal interact in both directions: that is, malignant growths could affect hemostasis and components involved in hemostasis could affect malignant growths. Interactions in the first direction are exemplified by the association of various types of thromboembolism with malignancy, including DIC in patients with disseminated malignant diseases. It is also noted that thrombocytopenia, whether due to crowding out of megakaryocytes by malignant invasion of the bone marrow or exposure to radiation or chemotherapeutic drugs, is a common cause of hemorrhage in malignancy. Depression of coagulation factors may result from obstructive jaundice or liver dysfunction. Since hemorrhage is a common symptom even in cases of malignancy without marked disturbance in hemostasis, it is of importance to rule out bleeding tendency including DIC by the results of "screening tests" for hemostatic abnormality. Massive hemorrhage may occasionally occur in patients with malignancy regardless of their hemostatic state. Treatment of these life-threatening massive hemorrhages in patients with or without bleeding tendency is described.
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PMID:[Diagnosis and treatment of oncologic emergency due to bleeding]. 660 16

The effects of operative trauma and obstructive jaundice on systemic immunity were studied in a rat model, using the delayed-type hypersensitivity response to 2,4-dinitro-1-fluorobenzene as a measure of systemic immune responsiveness. Midline laparotomy caused a significant decrease in the mean(s.e.m.) delayed-type hypersensitivity response 1 week after operation (4.6(1.3) versus 19.0(2.2) per cent for controls). The response returned to control levels by 2 weeks (14.6(3.1) per cent). Common bile duct ligation and division resulted in a significantly depressed hypersensitivity response at 2 and 3 weeks (6.8(2.0) and 8.4(1.6) per cent respectively). The expected decrease in the response at 1 week in these animals was not observed (mean(s.e.m.) 12.7(2.7) per cent), suggesting a possible role for the normal liver in the induction of postoperative immune depression. Impaired function of the reticuloendothelial system was induced in non-jaundiced animals by Kupffer cell ablation following intraportal infusion of lambda-carrageenan. A similar prevention of postoperative immune hyporesponsiveness was observed (mean(s.e.m.) 10.4(1.0) versus 10.4(1.6) per cent for controls). Hepatic Kupffer cells play an important role in the induction of postoperative immune depression.
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PMID:Postoperative immunological function and jaundice. 815 56

Using CD series monoclonal antibody indirect immune fluorescent assay and LDH enzyme-release assay, we investigated lymphocyte subsets and natural killer cells (NKC) activity in the peripheral blood of 30 patients with obstructive jaundice. The results showed that the percentage of CD3+, CD4+, B cells and that of CD8+ was high. The ratio of CD4/CD8 was low at the first 10 days of jaundice when the serum bilirubin level was less than 171 mumol/L. Our studies suggested that obstructive jaundice might cause depression and impairment of host cellular and humoral immunity. Further studies showed that impaired immune function of jaundiced patients returned to normal 30 days after the disappearance of the jaundice by external or internal biliary drainage. Immune function recovered 30 days after relief of biliary obstruction and external or internal biliary drainage. External or internal biliary drainage was useful in improving host immunity.
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PMID:[Effects of obstructive jaundice on immunocompetence in jaundiced patients]. 822 24


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