Changes in production of interleukin-1 and interleukin-2 associated with obstructive jaundice and biliary drainage in patients with gastrointestinal cancer

Increased susceptibility to infection in patients with obstructive jaundice has been well documented in vitro and in vivo. Nevertheless, an underlying mechanism for immunocompromise in these patients has not been identified. This study was undertaken to evaluate the production of two important immunoregulatory molecules, interleukin-1 (IL-1) and interleukin-2 (IL-2), by peripheral blood mononuclear cells in cancer patients with obstructive jaundice before and after percutaneous transhepatic biliary drainage (PTBD). After decompression with PTBD, IL-1 and IL-2 production was significantly increased (IL-1: from 7.9 +/- 4.9 to 13.9 +/- 4.9 U/ml, p less than 0.05; IL-2: from 8.8 +/- 4.9 to 14.1 +/- 6.5 U/ml, p less than 0.05). There was a positive correlation between IL-1 and IL-2 production (r = 0.424, p less than 0.05). The production of both interleukins correlated negatively with serum total bilirubin level (IL-1 r = -0.478, p less than 0.05; IL-2: r = -0.482, p less than 0.05) and positively with high-density lipoprotein cholesterol in serum (IL-1: r = 0.505, p less than 0.01; IL-2: r = 0.494, p less than 0.05). IL-2 production also correlated positively with serum albumin levels (r = 0.511, p less than 0.01). These results suggest that hyperbilirubinemia and abnormal lipid metabolism may be associated with impaired interleukin production, which may result in an increased susceptibility to infection during obstructive jaundice.