Immunohistochemistry of the liver and biliary tree in extrahepatic biliary atresia

Autor: Michael Tredger, C Gonde, Giorgina Mieli-Vergani, R Redkar, B Portmann, Mark Davenport, G Koukoulis, E R Howard
Rok vydání: 2001
Předmět:
Pathology
medicine.medical_specialty
Extrahepatic Biliary Atresia
medicine.medical_treatment
CD4-CD8 Ratio
Intrahepatic bile ducts
Antigens
Differentiation
Myelomonocytic
Vascular Cell Adhesion Molecule-1
Portoenterostomy
Hepatic
Liver transplantation
Gastroenterology
Biliary atresia
Antigens
CD
Bile Ducts
Extrahepatic
Biliary Atresia
Internal medicine
Receptors
Transferrin
medicine
Humans
medicine.diagnostic_test
business.industry
Macrophages
Infant
Receptors
Interleukin-2
General Medicine
Jaundice
medicine.disease
Intercellular Adhesion Molecule-1
Prognosis
Immunohistochemistry
Lymphocyte Function-Associated Antigen-1
Antigens
Differentiation
B-Lymphocyte
Killer Cells
Natural
Liver
Biliary tract
Liver biopsy
Atresia
Pediatrics
Perinatology and Child Health
Surgery
medicine.symptom
business
E-Selectin
Zdroj: Journal of pediatric surgery. 36(7)
ISSN: 0022-3468
Popis: Progressive destruction of intrahepatic bile ducts may determine outcome in extrahepatic biliary atresia (EHBA) despite successful portoenterostomy. The aim of this study was to characterize the inflammatory infiltrate of a large series of cases of biliary atresia and relate these findings to clinical outcome.Immunohistochemical analysis was performed on frozen tissue sections of extrahepatic biliary tree and liver biopsies obtained (August 1996 to March 1998) from 28 infants with EHBA and 8 liver biopsy specimens from age-matched controls with other cholestatic liver disorders. A semiquantitative scoring system was designed to evaluate the staining with a panel of antibodies to the CD4, CD8, CD25, CD56, CD68, CD71 antigens and to HLA-DR, ICAM-1, VCAM-1, E-selectin and LFA-1. The infants then underwent followup prospectively and divided into 2 prognostic groups at 12 months postoperatively: those who had cleared their jaundice (graded as a good outcome [n = 19]), and those who required liver transplantation or who had failed to clear their jaundice (defined as50 micromol/L; graded as poor outcome [n = 9]).CD4(+) lymphocytes and CD56(+) (NK cells) predominated in the liver of infants with EHBA as compared with controls. The infiltrating cells exhibited marked proliferation (CD71 expression) and activation (particularly LFA-1 but also CD25 expression). A smaller subpopulation of the cells also expressed VCAM and E-selectin. HLA-DR was strongly expressed on Kupffer cells and to a lesser extent on proliferating bile ducts and sinusoidal endothelium. Expression of the majority of markers was lower in the remnant bile duct tissue than in the liver of EHBA (P.05) with only HLA-DR and LFA-1 (on infiltrating cells) and ICAM (on endothelium) expressed strongly in the remnant bile duct tissue. Although quantitatively less pronounced, all of these immunohistochemical features also were noted in non-EHBA cholestatic liver tissue. A good outcome at 12 months was associated with lower CD68 (macrophage) expression in both the liver (P.05) and biliary tree (P.05) and with reduced expression of ICAM-1 (P =.05) on infiltrating cells in the biliary remnant.Immunohistochemical patterns of immune-mediated liver injury and inflammation were prevalent features at the time of portoenterostomy. They were neither exclusive to nor characteristic of EHBA. A reduction in the expression of the macrophage marker (CD68) within the liver and biliary remnants and reduction of ICAM-1 expression on infiltrating cells in the biliary remnants appear to be associated with a better postoperative prognosis.
Databáze: OpenAIRE
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