Kupffer Cell Modulation of the Systemic Immune Response

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Abstract
• The effects of global hepatic injury and of Kupffer cell activation on systemic immunity were studied in an in vivo rat model, using the diameters of the delayed-type hypersensitivity (DTH) response to keyhole limpet hemocyanin and of a subcutaneousStaphylococcus aureusabscess as measures of systemic immunoresponsiveness. Hepatic injury with carbon tetrachloride resulted in significant suppression of the DTH score (5.5±0.7 vs 8.8±0.8 mm). Kupffer cell activation with intraportalEscherichia coliwas likewise suppressive (DTH score, 4.4±0.5 vs 6.1±0.4 mm for animals receiving systemicE coli); the magnitude of this suppression correlated with the numbers of organisms extracted by the liver. Conversely, Kupffer cell ablation with carrageenan lessened the immunosuppressive effects of anesthesia and surgery (DTH score, 8.5±0.9 vs 6.8±0.6 mm for controls;S aureusabscess, 4.1±0.4 vs 5.7±0.4 mm for controls). These results indicate that Kupffer cells can modulate the systemic immune response and suggest that gram-negative portal bacteremia with resultant Kupffer cell activation may contribute to the immunologic derangements characteristic of trauma and critical surgical illness. (Arch Surg1987;122:191-196)