Neutrophil Priming by Cytokines in Patients With Obstructive Jaundice

Patients with obstructive jaundice frequently suffer postoperative complications. We have investigatedthe relationship of obstructive jaundice to the neutrophil oxidase response and the “priming” of theresponse by the cytokines TNFα, interleukin-1 (IL-1), IL-6, and IL-8. On stimulation with f-met-leuphe(fmlp), the respiratory burst in neutrophils from jaundiced patients was greatly increased comparedwith controls (p < 0.01), jaundiced patients having the highest respiratory burst levels were those withthe poorest prognosis. Neutrophils from controls were primed by all the cytokines tested, whereas“jaundiced” cells were primed only by IL-1, and not by TNFα, IL-6, or IL-8, which in fact producedslight inhibition. We conclude that neutrophils from obstructive jaundiced patients have raised oxidativeresponses which may be due to “pre-priming” in vivo by cytokines, such as IL-6, IL-8, or TNFα. This exaggeration of the oxidative response in circulating neutrophils may contribute to the peri-operatecomplications of patients with obstructive jaundice.