Phagocytosis and Production of H2O2 by Human Peripheral Blood Mononuclear Cells from Patients with Obstructive Jaundice

Background: The immune function is altered in jaundiced patients; here, the ability of their peripheral blood mononuclear cells to perform phagocytosis and to release H2 O2 was analyzed.Methods: Cells from 53 patients before surgery for relief of cholestasis, from 38 patients 1 week and from 15 patients 2 weeks after surgery were separated and cultured for 1 h in the presence of phorbol myristate acetate. H2 O2 release was evaluated colorimetrically and phagocytosis by the ingestion of Escherichia coliin vitro.Results: Before surgery for relief of cholestasis, the cells of the patients were unable to release H2 O2 , but, after surgery, an increasing percentage of patients had cells that were able to produce H2 O2 (13% after 1 week; 33% after 2 weeks). This recovery did not correlate with bilirubinemia. When cultured for 1 week in the presence of normal or jaundiced plasma, regardless of collection time, cells of 12/12 patients released H2 O2 , but in lower levels if in the presence of jaundiced plasma. In contrast, H2 O2 release by normal donor cells was enhanced in the presence of jaundiced plasma. Phagocytosis by cells of the patients was lower, but when present was associated with a significantly higher bactericidal activity.Conclusion: These significant, but reversible alterations of monocyte function in jaundiced patients might contribute to their enhanced susceptibility to surgical complications.