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Veränderungen des humoralen und zellulären Immunsystems beim frühen unkomplizierten Verschlußikterus

Changes of the humoral and cell-mediated immunity in early, uncomplicated obstructive jaundice

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Zusammenfassung

Eine vergleichende Analyse eines ikterischen und eines anikterischen Kollektivs in sonst klinisch übereinstimmendem Allgemeinzustand ergab, daß die bestimmten Zellkinine (IL-6, IL-2r) und Lymphozytenfaktoren (CD4, CD8) und immunkompetenten Eiweißkörper bei Patienten mit einem Verschlußikterus erhöhte Konzentrationen besitzen. Dieser Unterschied beträgt zwischen 197% (IL-6) und 105,1% (IgG) und ist für CD4, CD8, {ie250-1}, IgA, C3, Fibronektin und CRP signifikant, für IL-6, {ie250-2}, {ie250-3}, IgM und C4 verfehlt der Wert knapp die Signifikanzgrenze (p-0,1) und für IL-2r, AT III und IgG ist die Differenz nicht signifikant. Die Resultate werden als Steigerung des humoralen Immunsystems, insbesondere der Akutphasereaktion, aber auch der zellulären Immunität im ikterischen Kollektiv aufgefaßt. Als Ursache werden der Einfluß einer systemischen Endotoxinämie, einer herabgesetzten Phagozytoseleistung des RES und einer erniedrigten Metabolisierungsrate dieser Eiweißkörper diskutiert.

Summary

A comparative analysis of two matched groups of patients, one non-icteric and the other icteric with an early, uncomplicated obstructive jaundice, showed the icteric patients to have higher concentrations of cytokinins (IL-6, IL-2r), lymphocyte factors (soluble CD4, CD8), and immuno-competent proteins. The differencens in the concentrations range from 197% (IL-6) to 105.1% (IgG). They are significant for CD4, CD8, {ie250-4}, IgA, C3, fibronectin and CRP, narrowly miss the significance level (p-0.1) in the case of IL-6, {ie250-5}, {ie250-6}, IgM und C4, and show no significance for IL-2r, AT III und IgG. The results indicate a stimulation of the humoral immunity, especially of the acute phase reaction, as well as a stimulation of cell-mediated immunity in obstructive jaundice. Potential causes of these differences are systemic endotoxinemia, a diminished phagocytic capacity of RES and a reduced metabolism; the possible influence on the proteins is discussed.

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Authors and Affiliations

  1. Chirurgischen Abteilung des Kaiser-Franz-Josef-Spitals der Gemeinde Wien, Kundratstraße 3, A-1100, Wien

    F. Sellner & Ch. Neuwald

  2. Zentrallaboratorium des Kaiser-Franz-Josef-Spitals der Gemeinde Wien, Kundratstraße 3, A-1100, Wien

    F. Sellner & Ch. Neuwald

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  1. F. Sellner
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  2. Ch. Neuwald
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Sellner, F., Neuwald, C. Veränderungen des humoralen und zellulären Immunsystems beim frühen unkomplizierten Verschlußikterus. Acta Chir Austriaca 23, 250–257 (1991). https://doi.org/10.1007/BF02663240

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