lactoferrin and Bile-Duct-Diseases

After liver transplantation (LT), biliary complications are associated with reduced graft survival. We tested inflammation markers for their association with biliary damage and graft loss in bile.. The study design was a retrospective case-control study. Calprotectin, lactoferrin and pyruvate kinase were measured in endoscopically retrieved bile with ELISA.. Calprotectin and lactoferrin were significantly higher in bile of ischemic-type biliary lesions and donor duct non-anastomotic strictures than in control, bile leakage, Cytomegalovirus infection, anastomotic stricture or acute cellular rejection patients (p<0.001) independent of serum liver values at endoscopy. Calprotectin (p=0.02) was independently associated with retransplantation free survival in multivariate analysis, as was γGT (p=0.03) but not ERC radiographic classification of the bile duct or cold ischemia time.. Calprotectin and lactoferrin are bile markers for biliary damage and are associated with re-transplantation free survival. They can differentiate progressive biliary damage from non-biliary liver value alterations after LT.

Topics: Adult; Aged; Bile; Bile Duct Diseases; Biomarkers; Case-Control Studies; Female; Graft Survival; Humans; Lactoferrin; Leukocyte L1 Antigen Complex; Liver Transplantation; Male; Middle Aged; Postoperative Complications; Pyruvate Kinase; Retrospective Studies; Young Adult

Lactoferrin and lysozyme have bactericidal activities and are responsible for mucosal defense against local bacterial infections. To assess the local defense mechanisms in the intrahepatic biliary tree, we studied the distribution of lactoferrin and lysozyme immunohistochemically in 14 normal autopsy livers and in 29 surgically resected and two autopsy livers of hepatolithiasis. In the latter, bacterial infection was constantly found. Lactoferrin and lysozyme were detected in low doses and in specific areas in the intramural and extramural glands of certain normal livers. In contrast, in hepatolithiasis, the incidence of lactoferrin- and lysozyme-positive cases significantly increased both in the intramural glands (94% and 77% of 31 cases, respectively) and in the extramural glands (72% and 48% of 29 cases, respectively) (p less than 0.01) in the stone-containing bile ducts. These glands proliferated considerably in the stone-containing bile ducts and were stained more widely and intensely than in normal livers. These data suggest that these proliferated peribiliary glands in the stone-containing bile ducts produce and secrete significant amounts of lactoferrin and lysozyme. Increased production and secretion of lactoferrin and lysozyme suggests activated local defense mechanisms against bacterial infection in the stone-containing bile ducts, and may be beneficial for inhibition of the growth of calculi and prevention of the suppurative inflammation.

Topics: Adult; Aged; Aged, 80 and over; Autopsy; Bile Duct Diseases; Bile Ducts, Intrahepatic; Cholelithiasis; Humans; Immunohistochemistry; Lactoferrin; Liver; Middle Aged; Muramidase; Statistics as Topic