A study was conducted to elucidate the correlation between the plasma retinol transport system and taste acuity in patients with obstructive jaundice (OJ). Plasma levels of retinol, retinol-binding protein (RBP), transthyretin (TTR) and holo-RBP (retinol-RBP complex unbound to TTR), as well as the threshold of taste acuity, were determined in 8 cases with OJ (6 cases with common bile duct cancer and 2 cases with pancreas head cancer) and in 20 apparently healthy volunteers. These parameters were also measured serially in patients with OJ before and after percutaneous transhepatic biliary drainage (PTBD). Plasma levels of retinol, RBP and TTR were significantly decreased in every patients with OJ as compared with healthy controls, whereas changes in holo-RBP levels were not consistent. Taste acuity was found to be reduced in patients with decreased holo-RBP levels, while the acuity was preserved well in patients whose holo-RBP levels remained normal. Impaired taste acuity was rapidly improved in every patients after treatment with PTBD, significantly correlating with the recovery of plasma RBP and holo-RBP levels, and with the reduction of plasma total bilirubin levels. These results suggest that taste acuity is affected by the plasma retinol transport system, including serum levels of holo-RBP, from which retinol is delivered, presumably through a receptor-mediated manner, to the taste buds.