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Correction With Portacaval Shunt

Alfred Ayala, PhD; Yizheng Tu, MD, PhD; M. Wayne Flye, MD, PhD; Irshad H. Chaudry, PhD

Arch Surg. 1996;131(11):1209-1215.

Abstract
Objective
To determine whether redirecting intestinal blood flow away from the liver via a portacaval shunt would protect distal immune responses in the spleen after hemorrhage.

Design
Type C3H/HeN male mice in which a portacaval shunt had been established 2 to 3 weeks before the experiment were bled, their blood pressure was maintained at 35 mm Hg for 1 hour, and then they were resuscitated. Twenty-four hours later, the mice were killed, and mixed and adherent splenocyte cultures were established. The proliferative capacity of splenocytes, the release of interleukin-2 and interleukin-4, and the ability of splenic macrophages to present the antigen, conalbumin, were then determined as indexes of immunocompetence.

Results and Conclusions
The results indicate that splenocyte proliferation and splenocyte interleukin-2, but not interleukin-4, release were decreased and that splenic macrophage antigen presentation declined after hemorrhage. However, animals in which a portacaval shunt had been established before hemorrhage showed no such changes in their splenocyte or splenic macrophage functions. Thus, the decline of splenic immune responses after hemorrhage seems to be due to mediators released from the gut. Such mediators, in turn, stimulate Kupffer cells to secrete additional agents that produce immunosuppressive exocrine effects on splenic immune functions.

Arch Surg. 1996;131:1209-1215

Author Affiliations
From the Shock and Trauma Research Institute of the Department of Surgery, Michigan State University, East Lansing (Drs Ayala and Chaudry); the Center for Surgical Research in the Department of Surgery at Rhode Island Hospital, Brown University, Providence (Drs Ayala and Chaudry); and the Department of Surgery, Washington University School of Medicine, St Louis, Mo (Drs Tu and Flye).

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