Abstract
This study was undertaken to elucidate the reasons for the predilection toward infection in patients with biliary obstructions. We thus studied the cell-mediated immunity of 41 such patients, and laboratory evaluation of cellular responses, PPD skin reaction, lymphoproliferation to Phytohemagglutinin, Autoplasma Inhibition and other factors were studied in 20 benign patients and in 21 with malignancy. Serum concentration of direct bilirubin in patients correlated with reaction to PPD antigen, CRP, C4and α1-Antitrypsin. Autoplasma from patients with obstructive jaundice inhibited lymphoproliferation to PHA, moreover, Autoplasma Inhibition correlated well with direct bilirubin, and α1-Antitrypsin also increased in patients correlated with Autoplasma Inhibition. The results of the present study suggest that the depressed immunity in obstructive jaundice is not only due to the depression of lymphocytic function, but that obstructive jaundice sera contains immunosuppressive substances and it is this suppression of cellular immune response which appears to be induced by α1-Antitrypsin. In conclusion, depressed cellular immunity in biliary obstructed patients is not a direct factor in their predilection toward infection, but it has been suggested as a contributing element.
