To investigate the changes of serum endotoxin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and inducible nitric oxide synthase (iNOS) expression by Kupffer cells after relief of obstructive jaundice (OJ) by internal biliary drainage (ID) and external biliary drainage (ED) in rats.Materials and Methods:
Forty eight adult Sprague Dawley rats were randomly assigned to four groups: OJ, ID, ED and sham operation (SH). Inducible nitric oxide synthase mRNA by the Kupffer cells was detected by reverse transcription polymerase chain reaction. The serum TNF-α and IL-6 were measured by enzyme linked immunosorbent assay and endotoxin by kinetic turbidimetric limulus tests.Results:
Serum endotoxin, IL-6 and TNF-α levels were significantly elevated in OJ rats compared to that of SH rats (P < 0.01). After relief from OJ, the elevated endotoxin, IL-6 and TNF-α levels could be significantly depressed by ID (P < 0.01). However, the serum IL-6 level was increased in ED rats (P < 0.05) and the TNF-α level was not depressed by ED. Expression of iNOS mRNA by Kupffer cells was markedly stronger in the OJ group than in the SH group (P = 0.005). After relief from OJ, the iNOS mRNA expression was suppressed by ID (P = 0.139, ID vs OJ). However, the iNOS mRNA expression was promoted by ED (P = 0.321 ED vs OJ; P = 0.016 ED vs SH).Conclusions:
The levels of serum endotoxin, TNF-α and IL-6 and the expression of iNOS mRNA by Kupffer cells were increased in rats with obstructive jaundice. Internal biliary drainage could entirely reverse the changes, but external drainage only partially did.