lactoferrin and Cholelithiasis

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

Lactoferrin as assayed by a radial immunodiffusion technique was studied in pure pancreatic juice collected at endoscopic retrograde cholangiopancreatography from 23 patients with chronic pancreatitis, 12 with acute pancreatitis, 21 with pancreatic cancer, and 29 cases of nonpancreatic gastrointestinal disease. No clear difference between lactoferrin concentrations in the chronic pancreatitis patients and other groups was found. Moreover, most lactoferrin levels were below the limit of detection in our assay. In addition, lactoferrin total protein ratios did not appear to be of value in the differential diagnosis of chronic pancreatitis. These results seem to be in contrast to the findings of other authors, who measured lactoferrin in duodenal fluid--which is unreliable, in our opinion--or who mainly studied chronic pancreatitis patients and few other pancreatic diseases. Lactoferrin might well be a nonspecific marker for serious pancreatic inflammation.

Topics: Acute Disease; Cholelithiasis; Chronic Disease; Female; Humans; Immunodiffusion; Lactoferrin; Lactoglobulins; Male; Pancreatic Juice; Pancreatic Neoplasms; Pancreatitis