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John C. Marshall, MD, FRCS(C); Chen Lee, MD; Jonathan L. Meakins, MD, DSc, FRCS(C); Rene P. Michel, MD, FRCP(C); Nicolas V. Christou, MD, PhD, FRCS(C)

Arch Surg. 1987;122(2):191-196.

Abstract
• The effects of global hepatic injury and of Kupffer cell activation on systemic immunity were studied in an in vivo rat model, using the diameters of the delayed-type hypersensitivity (DTH) response to keyhole limpet hemocyanin and of a subcutaneous Staphylococcus aureus abscess as measures of systemic immunoresponsiveness. Hepatic injury with carbon tetrachloride resulted in significant suppression of the DTH score (5.5±0.7 vs 8.8±0.8 mm). Kupffer cell activation with intraportal Escherichia coli was likewise suppressive (DTH score, 4.4±0.5 vs 6.1±0.4 mm for animals receiving systemic E coli); the magnitude of this suppression correlated with the numbers of organisms extracted by the liver. Conversely, Kupffer cell ablation with carrageenan lessened the immunosuppressive effects of anesthesia and surgery (DTH score, 8.5±0.9 vs 6.8±0.6 mm for controls; S aureus abscess, 4.1±0.4 vs 5.7±0.4 mm for controls). These results indicate that Kupffer cells can modulate the systemic immune response and suggest that gram-negative portal bacteremia with resultant Kupffer cell activation may contribute to the immunologic derangements characteristic of trauma and critical surgical illness.

(Arch Surg 1987;122:191-196)

Author Affiliations
From the Departments of Surgery (Drs Marshall, Lee, Meakins, and Christou), Microbiology (Drs Meakins and Christou), and Pathology (Dr Michel), McGill University and Royal Victoria Hospital, Montreal.

Footnotes
Accepted for publication June 3, 1986.

Read before the Sixth Annual Meeting of the Surgical Infection Society, Chicago, April 21, 1986.

Reprint requests to Royal Victoria Hospital, Room S10.30, 687 Pine Ave W, Montreal, Quebec, Canada H3A 1A1 (Dr Christou).

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