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Chusilp S, Balsamo F, Li B, Vejchapipat P, Pierro A. Development of liver inflammatory injury in biliary atresia: from basic to clinical research. Pediatr Surg Int 2023; 39:207. [PMID: 37249714 DOI: 10.1007/s00383-023-05489-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2023] [Indexed: 05/31/2023]
Abstract
Biliary atresia (BA) is a severe cholangiopathy in infants. It is characterized by inflammatory fibro-obliteration of the intra- and extrahepatic bile ducts. Although the restoration of bile flow can be successful after Kasai operation, the rapid progression of liver fibrosis can continue, leading to cirrhosis. It is believed that the progression of liver fibrosis in BA is exacerbated by complicated mechanisms other than the consequence of bile duct obstruction. The fibrogenic cascade in BA liver can be divided into three stages, including liver inflammatory injury, myofibroblast activation, and fibrous scar formation. Recent studies have revealed that the activation of an immune response following bile duct injury plays an important role in promoting the inflammatory process, the releasing of inflammatory cytokines, and the development of fibrogenesis in BA liver. In this article, we summarized the evidence regarding liver inflammatory injury and the possible mechanisms that explain the rapid progression of liver fibrosis in BA.
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Affiliation(s)
- Sinobol Chusilp
- Division of General and Thoracic Surgery, Translational Medicine Program, University of Toronto, The Hospital for Sick Children, 1526-555 University Ave, Toronto, ON, M5G 1X8, Canada
- Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Felicia Balsamo
- Division of General and Thoracic Surgery, Translational Medicine Program, University of Toronto, The Hospital for Sick Children, 1526-555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Bo Li
- Division of General and Thoracic Surgery, Translational Medicine Program, University of Toronto, The Hospital for Sick Children, 1526-555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Paisarn Vejchapipat
- Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Agostino Pierro
- Division of General and Thoracic Surgery, Translational Medicine Program, University of Toronto, The Hospital for Sick Children, 1526-555 University Ave, Toronto, ON, M5G 1X8, Canada.
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2
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Kotb MA, Ieiri S, Shehata SM. Editorial: Elimination of biliary atresia. Front Pediatr 2023; 11:1202727. [PMID: 37284287 PMCID: PMC10241068 DOI: 10.3389/fped.2023.1202727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 04/24/2023] [Indexed: 06/08/2023] Open
Affiliation(s)
- Magd Ahmed Kotb
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Satoshi Ieiri
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan
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3
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Bove KE, Finegold MJ, Harpavat S. Biliary Atresia Remnants Revisited: Myogenesis, Hepatic Duct-Like Structures, and Fate of Peribiliary Glands. Pediatr Dev Pathol 2023:10935266221146042. [PMID: 36843487 DOI: 10.1177/10935266221146042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
PURPOSE AND CONTEXT Proximal levels of excised remnants from youngest infants may reveal early features of biliary atresia (BA). METHOD A targeted IHC survey was applied to 34 most proximal 2 levels in 17 BA remnants excised at age 10-74 days including 7 = <30 days old and 6 control hepatic ducts (HD). KEY RESULTS Severity of inflammation and extent of active fibroplasia do not distinguish proximal remnants in younger (n = 7) and older (n = 10) infants. In 27/34 levels of 14/17 remnants, reactive stroma is focally SM-MHC-2 (+), marking smooth muscle myosin, termed reactive myogenesis (RM), that is absent in controls. RM facilitates identification of 3 novel hepatic duct remnants (HDR): an HD-like collagen collar lined by degenerating cholangiocytes (n = 5); erosion defects in loose reactive stroma (n = 14); solitary foci of hyperplastic squamoid epithelium (n = 4). Peribiliary glands are either hyperplastic or atretic and typically lack RM. CONCLUSION Minimally inflammed end-stage lesions in BA remnants occur at youngest ages favoring prenatal onset. Three novel HDR are defined. RM, a useful surrogate for HDR, is a prevalent inappropriate stromal reaction in proximal remnants of uncertain biological significance. RM is the source of mature smooth muscle in BA remnants.
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Affiliation(s)
- Kevin E Bove
- Department of Pathology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Milton J Finegold
- Department of Pathology-Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Sanjiv Harpavat
- Department of Pediatrics-Gastroenterology, Baylor College of Medicine, Houston, TX, USA
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4
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Liang M, Tai W, Wang Y, Dai Y, Yao Y, Min J, Zhou Y, Liu L, Shan C, Xia H, Yuan Z. SARS-CoV-2 infection induces testicular injury in Rhesus macaque. Virol Sin 2022; 37:934-937. [PMID: 36374663 PMCID: PMC9613785 DOI: 10.1016/j.virs.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
The infection of SARS-CoV-2 lead to varying degrees of testicular pathological damage. The NP antigen of SARS-CoV-2 was not found in male reproductive system of rhesus macaque. Infection-associated inflammatory insult and sex hormone fluctuations may account for the testicular pathophysiology.
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Affiliation(s)
- Mengying Liang
- Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430061, China,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Wanbo Tai
- Institute of Infectious Diseases, Shenzhen Bay Laboratory, Shenzhen, 518069, China
| | - Yunyun Wang
- Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yulong Dai
- Institute of Infectious Diseases, Shenzhen Bay Laboratory, Shenzhen, 518069, China
| | - Yanfeng Yao
- Wuhan National Biosafety Laboratory, Chinese Academy of Sciences, Wuhan, 430073, China
| | - Juan Min
- The Core Facility and Technical Support, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430061, China
| | - Yiwu Zhou
- Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Liang Liu
- Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Chao Shan
- University of Chinese Academy of Sciences, Beijing, 100049, China,State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430061 China
| | - Han Xia
- Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430061, China,University of Chinese Academy of Sciences, Beijing, 100049, China,Corresponding authors.
| | - Zhiming Yuan
- Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430061, China,University of Chinese Academy of Sciences, Beijing, 100049, China,Corresponding authors.
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5
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Kotb MA, Kotb A, Talaat S, Shehata SM, El Dessouki N, ElHaddad AA, El Tagy G, Esmat H, Shehata S, Hashim M, Kotb HA, Zekry H, Abd Elkader HM, Kaddah S, Abd El Baky HE, Lotfi N. Congenital aflatoxicosis, mal-detoxification genomics & ontogeny trigger immune-mediated Kotb disease biliary atresia variant: SANRA compliant review. Medicine (Baltimore) 2022; 101:e30368. [PMID: 36181129 PMCID: PMC9524989 DOI: 10.1097/md.0000000000030368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Biliary atresia (BA) is the most common indication for pediatric liver transplantation. We describe The BA variant: Kotb disease. Liver tissue in the Kotb disease BA is massively damaged by congenital aflatoxicosis resulting in inflammation, adhesions, fibrosis, bile duct proliferation, scarring, cholestasis, focal syncytial giant cell transformation, and typical immune response involving infiltration by CD4+, CD8+, CD68+, CD14+, neutrophil infiltration, neutrophil elastase spill, heavy loads of aflatoxin B1, accelerated cirrhosis, disruption of p53 and GSTPi, and have null glutathione S transferase M1 (GSTM1). All their mothers are heterozygous for GSTM1. This inability to detoxify aflatoxicosis results in progressive inflammatory adhesions and obliterative cholangiopathy early in life. The typical disruption of both p53 and GSTPi causes loss of fidelity of hepatic regeneration. Hence, regeneration in Kotb disease BA typically promotes accelerated cirrhosis. The immune response in Kotb disease BA is for damage control and initiation of regeneration, yet, this friendly fire incurs massive structural collateral damage. The Kotb disease BA is about actual ongoing hepatic entrapment of aflatoxins with lack of ability of safe disposal due to child detoxification-genomics disarray. The Kotb disease BA is a product of the interaction of persistent congenital aflatoxicosis, genetic lack of GSTM1 detoxification, ontogenically impaired activity of other hepatic detoxification, massive neutrophil-elastase, immune-induced damage, and disturbed regeneration. Ante-natal and neonatal screening for aflatoxicosis, avoiding cord milking, and stringent control of aflatoxicosis content of human, poultry and live-stock feeds might prove effective for prevention, prompt diagnosis and management based on our recent understanding of its patho-genomics.
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Affiliation(s)
- Magd A. Kotb
- Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
- *Correspondence: (e-mail: )
| | - Ahmed Kotb
- Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | - Sahar Talaat
- Department of Pathology, Faculty of Medicine, Cairo University, Egypt
| | - Sherif M. Shehata
- Department of Pediatric Surgery, Faculty of Medicine, Tanta University, Egypt
| | - Nabil El Dessouki
- Department of Pediatric Surgery, Faculty of Medicine, Cairo University, Egypt
| | - Ahmed A. ElHaddad
- Department of Pediatric Surgery, Faculty of Medicine, Tanta University, Egypt
| | - Gamal El Tagy
- Department of Pediatric Surgery, Faculty of Medicine, Cairo University, Egypt
| | - Haytham Esmat
- Department of Pediatric Surgery, Faculty of Medicine, Cairo University, Egypt
| | - Sameh Shehata
- Department of Pediatric Surgery, Faculty of Medicine, Alexandria University, Egypt
| | - Mohamed Hashim
- Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | - Hanan A. Kotb
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Egypt
| | - Hanan Zekry
- Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | | | - Sherif Kaddah
- Department of Pediatric Surgery, Faculty of Medicine, Cairo University, Egypt
| | | | - Nabil Lotfi
- Faculty of Medicine, Cairo University, Egypt
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6
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Zhang J, Luo Y, Feng M, Xia Q. Identification of Liver Immune Microenvironment-Related Hub Genes in Liver of Biliary Atresia. Front Pediatr 2021; 9:786422. [PMID: 35111704 PMCID: PMC8802228 DOI: 10.3389/fped.2021.786422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/24/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Biliary atresia (BA) is one of the most common and fatal abnormalities of newborns. Increasing evidences indicated that immunology was the critical part of the etiology. This research used a public gene expression database to explore the immune microenvironment of BA liver. Methods: The gene expression profiles GSE46960, GSE159720, and GSE15235, containing BA and normal liver gene expression data, were obtained from the Expression Omnibus Gene. We applied CIBERSORTx to quantify 22 subsets of immune cells in BA liver. The differentially expressed genes (DEGs) and immune cells were used to further explore their relationship with liver fibrosis and the inflammation status of BA. Results: The expression of immune-related genes CXCL6, CXCL8, CXCL10, CCL20, IL32, TGFB2, SPP1, and SLIT2 was significantly different between BA and normal liver, among which CXCL8 was the hub gene. Six of 22 immune cell proportions were significantly different between BA and normal liver. Specifically, M0 macrophages and resting memory CD4+ T cells were upregulated in BA liver compared with normal liver. Meanwhile, monocytes, resting natural killer (NK) cells, plasma cells, and regulatory T (Treg) cells were downregulated. A further correlation analysis revealed that SLIT2 and CXCL6 owned high positive correlation coefficients with fibrosis grade, while the proportion of resting NK cells was negatively correlated. Proportions of resting CD4+ memory T cells were strongly related to the inflammation grade of BA liver. Conclusion: Biliary atresia is a disease strongly correlated with immune response. Our results might provide a clue for further exploration of BA etiology, which may promote a potential prediction model based on immune infiltration features.
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Affiliation(s)
- Jiaxu Zhang
- Department of Liver Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Luo
- Department of Liver Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Transplantation, Shanghai, China
| | - Mingxuan Feng
- Department of Liver Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Transplantation, Shanghai, China
| | - Qiang Xia
- Department of Liver Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Transplantation, Shanghai, China
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7
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Wang Y, Xie X, Cao Q, Xie W, Chen D, Zhang X, Guo Y, Zhou L. Quantitative Contrast-Enhanced Ultrasound by Sonazoid in the Early Diagnosis of Biliary Atresia: An Experimental Study of Rats With Bile Duct Ligation. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2767-2776. [PMID: 31345651 DOI: 10.1016/j.ultrasmedbio.2019.06.409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 06/08/2019] [Accepted: 06/19/2019] [Indexed: 06/10/2023]
Abstract
We aimed to investigate the feasibility of quantitative Sonazoid contrast-enhanced ultrasound (CEUS) in the diagnosis of biliary atresia (BA) at an early disease stage. First, liver tissue from 10 patients with BA and 10 patients with infantile hepatitis syndrome (IHS) was immunostained with cluster of differentiation 68 (CD68) to compare Kupffer cell counts. Then, quantitative Sonazoid CEUS was performed to evaluate the hyperplasia of the artery branches during the artery phase and changes in Kupffer cell counts during the Kupffer phase in a rat model of BA (common bile duct ligation). Based on our results, liver enhancement from Kupffer cells in BA patients was significantly higher than that in IHS patients (p = 0.026 < 0.05). Furthermore, quantitative CEUS showed that the liver enhancement intensity of rats with bile duct ligation was substantially greater than that of rats without bile duct ligation during the artery phase 3 d post-operation and the Kupffer phase 5 d post-operation. The increased enhancement intensity in the Kupffer phase was in agreement with the increase in Kupffer cell counts in pathologic staining (18/20, 90%). In conclusion, quantitative Sonazoid CEUS can detect the hyperplasia of artery branches in artery phase and the increase of Kupffer cells in Kupffer phase in the liver of BA rats at an early disease stage. Therefore, Sonazoid CEUS could potentially be a valuable non-invasive alternative for the diagnosis of BA.
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Affiliation(s)
- Yangdi Wang
- Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China
| | - Xiaoyan Xie
- Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China
| | - Qinghua Cao
- Department of Pathology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China
| | - Wenxuan Xie
- Department of General Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China
| | - Dong Chen
- Department of General Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China
| | - Xiaoer Zhang
- Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China
| | - Yu Guo
- Department of General Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China
| | - Luyao Zhou
- Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China.
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8
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Abstract
BACKGROUND Biliary atresia (BA) is the most common cause of obstructive jaundice in infants. Although the Kasai procedure has greatly improved the prognosis, most patients still need liver transplantation (LT) for long-term survival. The pathogenesis of BA has not been fully clarified, and liver fibrosis in BA is far beyond biliary obstructive cirrhosis. DATA SOURCES Literature reviews were underwent through PubMed. Persistent inflammation, immune response, biliary epithelial-mesenchymal transition, matrix deposition, decompensated angiogenesis, and unique biliary structure development all contribute to the fibrosis process. Observed evidences in such fields have been collected and form the backbone of this review. RESULTS Interactions of the multiple pathways accelerate this process. CONCLUSIONS Understanding the mechanisms of the liver fibrosis in BA may pave the way to improved survival after the Kasai procedure.
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Affiliation(s)
- Wen-Jun Shen
- Department of Pediatric Surgery, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Gong Chen
- Department of Pediatric Surgery, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Min Wang
- Department of Pediatric Surgery, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Shan Zheng
- Department of Pediatric Surgery, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
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9
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Jiang H, Gao P, Chen H, Zhong Z, Shu M, Zhang Z, She J, Liu J. The Prognostic Value of CD8 + and CD45RO + T Cells Infiltration and Beclin1 Expression Levels for Early Postoperative Cholangitis of Biliary Atresia Patients after Kasai Operation. J Korean Med Sci 2018; 33:e198. [PMID: 30034306 PMCID: PMC6052325 DOI: 10.3346/jkms.2018.33.e198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 04/12/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Postoperative cholangitis is a common but severe complication after Kasai portoenterostomy for biliary atresia (BA). This study aimed to identify its prognostic factors. METHODS Two sets of liver paraffin-embedded tissue samples were collected from BA patients who received Kasai portoenterostomy (n = 25 and n = 31, respectively). Patients were divided into non-cholangitis and cholangitis groups. The infiltration of CD4+, CD8+, CD45RO+, CD68+ cells and expression of Beclin1 were quantitatively evaluated in immunohistochemical analysis. RESULTS Cholangitis group had a significantly lower CD8+ T cell infiltration but a higher CD45RO+ cell infiltration, and a lower Beclin1 level than non-cholangitis group (all P < 0.01). Multivariate logistic regression analysis indicated that infiltration of CD8+ cells (odds ratio [OR], 0.112; 95% confidence interval [CI], 0.022-0.577) and CD45RO+ cells (OR, 3.88; 95% CI, 1.37-11.03), and Beclin1 level (OR, 0.088; 95% CI, 0.018-0.452) were independent influence factors for early postoperative cholangitis. Receiver operating characteristic (ROC) analysis showed that area under ROC curve (AUROC) values for CD8+ cells, CD45RO+ cells and Beclin1 were 0.857, 0.738 and 0.900, respectively. CONCLUSION Our findings demonstrated the CD8+ cells, CD45RO+ cells and Beclin1 level possessed the prognostic value for early postoperative cholangitis following Kasai operation, which may be helpful to develop new prevention and treatment strategies for postoperative cholangitis.
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Affiliation(s)
- Hong Jiang
- Department of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Pengfei Gao
- Department of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Huadong Chen
- Department of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhihai Zhong
- Department of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Man Shu
- Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhichong Zhang
- Department of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jinbiao She
- Department of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Juncheng Liu
- Department of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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10
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Yang Y, Dong R, Zheng C, Zheng S, Chen G. Infiltration of polarized macrophages associated with liver fibrosis in infants with biliary atresia. J Pediatr Surg 2017; 52:1984-1988. [PMID: 28927974 DOI: 10.1016/j.jpedsurg.2017.08.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 08/28/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND/PURPOSE Macrophages exert critical functions in liver homeostasis and have been proposed as potential targets in combatting fibrosis. We aimed to evaluate polarized functional status of liver infiltrated macrophages in infants with biliary atresia (BA). METHODS Immunohistochemical staining for CD68, CD163, and IRF5 was performed in 40 BA infants. Liver biopsies were scored for fibrosis and tested for association with clinical biochemical characteristics. RESULTS Developing lesions in BA liver progressively accumulated both CD163+ macrophages (M2) and IRF5+ macrophages (M1), while CD163 and IRF5 staining was stronger than the control group (p<0.001). In BA, the higher staining density of CD163 and CD68 was related with elevated serum conjugated bilirubin level (p=0.014 and 0.021, respectively). The CD163/IRF5 macrophages ratio was related with liver fibrosis scores (high vs. low, p=0.004). CONCLUSIONS We demonstrated a strong presence of polarized macrophages in BA liver, and macrophage phenotypes were involved in disease development. The balance of different polarized macrophage subpopulations may play a key role in fibrogenesis of BA.
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Affiliation(s)
- Yifan Yang
- Department of Pediatric Surgery, Children's Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China
| | - Rui Dong
- Department of Pediatric Surgery, Children's Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China
| | - Chao Zheng
- Department of Pediatric Surgery, Children's Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China
| | - Shan Zheng
- Department of Pediatric Surgery, Children's Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China.
| | - Gong Chen
- Department of Pediatric Surgery, Children's Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China.
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11
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Wang PL, Wang J, Zhou Y, Chen XS, Zhou KJ, Wen J, Zhang JJ, Cai W. Expression of programmed death-1 and its ligands in the liver of biliary atresia. World J Pediatr 2017; 13:604-610. [PMID: 28332100 DOI: 10.1007/s12519-017-0018-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/20/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND An aberrant immune response is the predominant pathogenetic factor in biliary atresia (BA). Programmed death-1 (PD-1) and its two ligands, programmed death ligand-1 and programmed death ligand-2 (PD-L1 and PD-L2, respectively) play an important inhibitory role in immune reactions. We aimed to illustrate the expression of these molecules in BA. METHODS Liver specimens were obtained from infants with BA during the Kasai procedure (early BA) and liver transplantation (late BA). Intrahepatic expression of PD- 1, PD-L1, and PD-L2 were examined by immunostaining and compared with that in patients with neonatal hepatitis syndrome and normal controls. The correlation between the expression levels of these molecules in the liver and clinicopathological parameters was analyzed for each group. RESULTS Enhanced expression of PD-1 and its ligands occurred in the livers with early BA. In the BA-affected livers, PD-1 was correlated with the degree of peri-biliary inflammation, while PD-L2 was linked more directly with portal fibrosis. None of the three molecules was correlated with the prognosis of the Kasai procedure in patients with early BA. CONCLUSIONS Only PD-1 and PD-L1 are involved in the immune reactions of early BA. Elucidation of the detailed role of PD-L2 in BA requires further research.
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Affiliation(s)
- Pan-Liang Wang
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, No. 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China
| | - Jun Wang
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, No. 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China
| | - Ying Zhou
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, No. 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China
| | - Xiao-Song Chen
- Department of Transplantation and Hepatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ke-Jun Zhou
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Jie Wen
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Jian-Jun Zhang
- Department of Transplantation and Hepatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Wei Cai
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, No. 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China. .,Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. .,Shanghai Institute of Pediatric Research, Shanghai, China.
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12
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Endo K, Yokoi A, Mishima Y, Tamaki A, Morita K, Okata Y, Hisamatsu C, Fukuzawa H, Yoshida M, Akasaka Y, Maeda K. A case of biliary atresia with pancreaticobiliary maljunction. Surg Case Rep 2017; 3:100. [PMID: 28871567 PMCID: PMC5583132 DOI: 10.1186/s40792-017-0375-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 08/30/2017] [Indexed: 11/12/2022] Open
Abstract
Background The pathogenesis of biliary atresia (BA) is still unknown. There are several reports on the etiology of BA, including pancreaticobiliary maljunction (PBM). We experienced a case of Kasai type IIIa BA with PBM, in which we found elevation of pancreatic enzymes in the gallbladder. We evaluated whether PBM is related to the pathogenesis of BA based on our findings. Case presentation The patient was born at 40 weeks of gestation. His body weight at birth was 2850 g. At the age of 4 days, he had an acholic stool and was referred to our hospital. Abdominal ultrasonography showed that triangular cord sign was negative. The gallbladder was isolated with a diameter of 19 mm, and it contracted in response to oral feeding. His ultrasonographic findings were atypical for BA, but his jaundice did not improve. Therefore, we performed an operation at the age of 56 days. Intraoperative cholangiography showed a common bile duct and pancreatic duct and a common channel patent, while the common hepatic duct or intrahepatic duct was not visualized. Bile in the gallbladder contained colorless fluid, which showed elevated lipase level (34,100 IU/L). We performed Kasai portoenterostomy under the diagnosis of Kasai type IIIa BA with PBM. The patient’s postoperative course was uneventful, and he was discharged on day 30 after the operation. Histopathological evaluation showed that the lumens of the common bile duct and cystic duct were patent. However, the common hepatic duct was closed, and only bile ductules with diameters of less than 50 μm were isolated. Infiltration of lymphocytes was detected in the porta hepatis. No apparent inflammation was observed around the cystic duct, which was constantly exposed to pancreatic juice because of reflux through PBM. Conclusions Reflux of pancreatic juice through PBM might not be an etiological factor for BA, but might be associated with patency of the common and cystic bile ducts in Kasai type IIIa BA.
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Affiliation(s)
- Kosuke Endo
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 654-0081, Japan. .,Department of Pediatric Surgery, Kitano Hospital The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan.
| | - Akiko Yokoi
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 654-0081, Japan
| | - Yasuhiko Mishima
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 654-0081, Japan
| | - Akihiko Tamaki
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 654-0081, Japan
| | - Keiichi Morita
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 654-0081, Japan
| | - Yuichi Okata
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 654-0081, Japan
| | - Chieko Hisamatsu
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 654-0081, Japan
| | - Hiroaki Fukuzawa
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 654-0081, Japan
| | - Makiko Yoshida
- Department of Radiology, Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 654-0081, Japan
| | - Yoshinobu Akasaka
- Department of Pathology, Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 654-0081, Japan
| | - Kosaku Maeda
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 654-0081, Japan
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Wu B, Cui H, Peng X, Fang J, Zuo Z, Deng J, Wang X, Huang J. Toxicological effects of nickel chloride on the cytokine mRNA expression and protein levels in intestinal mucosal immunity of broilers. ENVIRONMENTAL TOXICOLOGY 2015; 30:1309-1321. [PMID: 24801245 DOI: 10.1002/tox.22001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 04/18/2014] [Accepted: 04/25/2014] [Indexed: 06/03/2023]
Abstract
The purpose of this study was to examine the toxicological effects of nickel chloride (NiCl2 ; 300, 600, and 900 mg kg(-1) diet) on the cytokine mRNA expression and protein levels in the intestinal mucosa and cecal tonsil, and on the ileac and cecal tonsil T cells in broilers by the methods of qRT-PCR, flow cytometry and ELISA for 42 days. Results showed that the IL-2, IL-6, IL-10, IL-17, IFN-γ, and TNF-α (LITAF) cytokine mRNA expression and protein levels were lower (P < 0.05 or P < 0.01) and the percentages of T-cell subsets were also lower in the 300, 600, and 900 mg kg(-1) groups than in the control group. It was concluded that dietary NiCl2 in excess of 300 mg kg(-1) could reduce cytokine mRNA expression and protein levels in the intestinal mucosa and cecal tonsil, and the percentages of ileac and cecal tonsil T-cell subsets. Decreasing in cytokine mRNA expression and protein levels of intestinal mucosa and cecal tonsil induced by NiCl2 was closely related to the reduction of T-cell population. Thus, the abnormal expression of these cytokines impacts the intestinal mucosal immune function by the pathways of reducing of lymphocyte population and activation. Also, this study first proved that NiCl2 at higher levels has the toxicological effects on intestinal mucosal immunity.
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Affiliation(s)
- Bangyuan Wu
- Department of Animal Diseases and Environmental Hazards, Key Laboratory of Animal Diseases and Environmental Hazards of Sichuan Province, Sichuan, China
| | - Hengmin Cui
- Department of Animal Diseases and Environmental Hazards, Key Laboratory of Animal Diseases and Environmental Hazards of Sichuan Province, Sichuan, China
- College of Veterinary Medicine, Sichuan Agricultural University, Ya'an, 625014, China
| | - Xi Peng
- Department of Animal Diseases and Environmental Hazards, Key Laboratory of Animal Diseases and Environmental Hazards of Sichuan Province, Sichuan, China
- College of Veterinary Medicine, Sichuan Agricultural University, Ya'an, 625014, China
| | - Jing Fang
- Department of Animal Diseases and Environmental Hazards, Key Laboratory of Animal Diseases and Environmental Hazards of Sichuan Province, Sichuan, China
- College of Veterinary Medicine, Sichuan Agricultural University, Ya'an, 625014, China
| | - Zhicai Zuo
- Department of Animal Diseases and Environmental Hazards, Key Laboratory of Animal Diseases and Environmental Hazards of Sichuan Province, Sichuan, China
- College of Veterinary Medicine, Sichuan Agricultural University, Ya'an, 625014, China
| | - Junliang Deng
- Department of Animal Diseases and Environmental Hazards, Key Laboratory of Animal Diseases and Environmental Hazards of Sichuan Province, Sichuan, China
- College of Veterinary Medicine, Sichuan Agricultural University, Ya'an, 625014, China
| | - Xun Wang
- College of Animal Science and Technology, Sichuan Agricultural University, Ya'an, 625014, China
| | - Jianying Huang
- Department of Animal Diseases and Environmental Hazards, Key Laboratory of Animal Diseases and Environmental Hazards of Sichuan Province, Sichuan, China
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Tang K, Guo H, Deng J, Cui H, Peng X, Fang J, Zuo Z, Wang X, Wu B, Li J, Yin S. Inhibitive effects of nickel chloride (NiCl₂) on thymocytes. Biol Trace Elem Res 2015; 164:242-52. [PMID: 25547965 DOI: 10.1007/s12011-014-0219-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 12/18/2014] [Indexed: 01/15/2023]
Abstract
The purpose of this study was to define the inhibitive effects of dietary nickel chloride (NiCl2) on thymocytes in broilers fed on diets supplemented with 0, 300, 600, and 900 mg/kg of NiCl2 for 42 days. We examined the changes of cell cycle phase, percentages of apoptotic cells, T cell subsets, cytokines, and mRNA expression of apoptotic proteins (bcl-2, bax, and caspase-3) in thymocytes by flow cytometry and quantitative real-time polymerase chain reaction (qRT-PCR). In the NiCl2-treated broilers, the percentages of thymocytes in G0/G1 phase were increased, whereas thymocytes in the S phase and the proliferation index were decreased. The percentages of apoptotic thymocytes were increased. Also, the mRNA expression levels of bax and caspase-3 were increased, and mRNA expression levels of bcl-2 were decreased. The percentages of CD3(+), CD3(+)CD4(+), and CD3(+)CD8(+) T lymphocytes in the thymus and peripheral blood were diminished. Concurrently, thymic cytokine (interleukin-1 beta (IL-1β), interleukin-2 (IL-2), interleukin-10 (IL-10), interleukin-12 p35 subunit (IL-12p35), interleukin-12 p40 subunit (IL-12p40), interleukin-21 (IL-21), interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), thymosin β4, thymosin β10, and thymosin β15) mRNA expression levels were decreased. The abovementioned results showed that dietary NiCl2 in excess of 300 mg/kg inhibited thymocyte growth by arresting cell cycle, increasing apoptosis percentage, altering apoptotic protein mRNA expression levels, and downregulating cytokine expression levels.
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Affiliation(s)
- Kun Tang
- Key Laboratory of Animal Diseases and Environmental Hazards of Sichuan Province, Sichuan Agricultural University, Ya'an, 625014, China
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Arva NC, Russo PA, Erlichman J, Hancock WW, Haber BA, Bhatti TR. The inflammatory phenotype of the fibrous plate is distinct from the liver and correlates with clinical outcome in biliary atresia. Pathol Res Pract 2015; 211:252-60. [PMID: 25624184 DOI: 10.1016/j.prp.2014.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 11/18/2014] [Accepted: 12/05/2014] [Indexed: 01/24/2023]
Abstract
Biliary atresia is an inflammatory cholangiopathy of still undetermined etiology. Correlations between histologic findings and clinical outcome in this disease have largely been based on evaluation of liver parenchyma. This study aimed to characterize the pattern of inflammation within the biliary remnant and identify associations between the type and degree of inflammation and clinical outcome as reflected by the transplant-free interval. The inflammation within the fibrous plates and livers of 41 patients with biliary atresia was characterized using immunohistochemical markers and the cell populations were digitally quantified. The type and quantity of cells within the infiltrate were then correlated with length of time from Kasai portoenterostomy until transplant. Histologic and immunohistochemical features of the biliary remnant allowed stratification of patients into "inflammatory plate" and "fibrotic plate" groups. Overall there was no significant difference in transplant-free interval between the two cohorts; however, there was a trend towards a longer time to transplant among patients in the "fibrotic plate" group. In addition, the composition of the inflammatory infiltrate in the fibrous plate was distinctly different from that present in the liver and only the characteristics of the inflammation in the fibrous plate, in particular the number of Foxp3+ T regulatory lymphocytes correlated with clinical outcome. The results of this study support the view of the extra-hepatic biliary tree as the primary site of injury in BA with the changes seen in the liver as secondary manifestations of outflow obstruction. The association between specific inflammatory cell subtypes within the fibrous plate and the length of transplant-free interval also supports the role of the immune system in the initial process of bile duct damage in biliary atresia.
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Affiliation(s)
- Nicoleta C Arva
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Pierre A Russo
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Jessi Erlichman
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Wayne W Hancock
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | | | - Tricia R Bhatti
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
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16
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Huang J, Cui H, Peng X, Fang J, Zuo Z, Deng J, Wang X, Wu B. Effect of dietary nickel chloride on splenic immune function in broilers. Biol Trace Elem Res 2014; 159:183-91. [PMID: 24807685 DOI: 10.1007/s12011-014-0003-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 04/28/2014] [Indexed: 01/15/2023]
Abstract
This study was designed to evaluate the effects of dietary nickel chloride (NiCl2) on the splenic immunity in broilers by observing changes of cytokine mRNA expression and protein levels, immunoglobulin (IgA, IgG, and IgM) contents, and IgA+ B cell and T-cell numbers using the methods of qRT-PCR, flow cytometry (FCM), and ELISA. A total of 240 1-day-old avian broilers were equally allocated into four groups and fed on a corn-soybean basal diet as the control diet or the same diet supplemented with 300, 600, and 900 mg/kg NiCl2 for 42 days. The mRNA expression and protein levels of IL-2, IL-6, IL-10, IL-12, TNF-α/LITAF, IFN-γ, and IgA, IgG, and IgM contents were significantly decreased (p<0.05 or p<0.01) in the 300-, 600-, and 900-mg/kg NiCl2 groups when compared with those of the control group, which was consistent with the reduction of T-cell subset percentages and IgA+ B cell numbers in the 300-, 600-, and 900-mg/kg NiCl2 groups. The abovementioned results showed that dietary NiCl2 in excess of 300 mg/kg caused damage on splenocytes and splenic immune function. The results of the present study provided new experimental evidences for further study on the effect mechanism of NiCl2 on splenic immunity.
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Affiliation(s)
- Jianying Huang
- Key Laboratory of Animal Diseases and Environmental Hazards of Sichuan Province, Ya'an, Sichuan, China, 625014
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Petersen C, Davenport M. Aetiology of biliary atresia: what is actually known? Orphanet J Rare Dis 2013; 8:128. [PMID: 23987231 PMCID: PMC3766137 DOI: 10.1186/1750-1172-8-128] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 08/23/2013] [Indexed: 01/27/2023] Open
Abstract
Biliary atresia (BA) is a rare disease of unknown etiology and unpredictable outcome, even when there has been timely diagnosis and exemplary surgery. It has been the commonest indication for liver transplantation during childhood for the past 20 years. Hence much clinical and basic research has been directed at elucidating the origin and pathology of BA. This review summarizes the current clinical variations of BA in humans, its occasional appearance in animals and its various manifestations in the laboratory as an experimental model.
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Affiliation(s)
- Claus Petersen
- Department of Pediatric Surgery, Hannover Medical School, Carl-Neuberg-Str, 1, 30625 Hannover, Germany.
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18
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Wang ZM, Chen YJ. Recent progress in understanding pathogenesis and liver pathology in biliary atresia. Shijie Huaren Xiaohua Zazhi 2012; 20:2576-2582. [DOI: 10.11569/wcjd.v20.i27.2576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Biliary atresia is an infantile destructive inflammatory cholangiopathy that causes obliteration of both intrahepatic and extrahepatic bile ducts and eventually liver cirrhosis. So far, the exact etiology and pathogenesis of biliary atresia remain unclear, and possible etiologies include congenital and genetic factors, infection, inflammation, immune reaction, maternal factors, and vascular factors. Immunoinflammatory theory has been accepted by most researchers, which is supported by liver pathological changes. This review focuses on the recent progress in understanding pathogenesis and liver pathology in biliary atresia.
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19
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Wang K, Cui H, Deng Y, Peng X, Fang J, Zuo Z, Cui W. Effect of dietary vanadium on the ileac T cells and contents of cytokines in broilers. Biol Trace Elem Res 2012; 147:113-9. [PMID: 22116680 DOI: 10.1007/s12011-011-9274-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 11/13/2011] [Indexed: 01/09/2023]
Abstract
The purpose of this 42-day study was to examine the effect of dietary vanadium on the ileac T cells and contents of cytokines including interleukin-2 (IL-2), interleukin-6 (IL-6), and interferon-gamma (IFN-γ) in broilers by flow cytometry and enzyme-linked immunosorbent assay. A total of 420 one-day-old avian broilers were divided into six groups (seven replicates in each group and ten broilers in each replicate) and fed on control diet or the same diet supplemented with 5, 15, 30, 45, and 60 mg/kg vanadium in the form of ammonium metavanadate. The results showed that the percentages of CD3(+), CD3(+)CD4(+), and CD3(+)CD8(+) T cells in both ileac lamina propria lymphocytes (LPLs) and intraepithelial lymphocytes (IELs) were significantly lower (P < 0.05 or P < 0.01) in the 45- and 60-mg/kg groups than in the control group from 14 to 42 days of age. The CD4(+)/CD8(+) ratio was increased in ileac LPLs in the 60-mg/kg group at 28 days of age, and in ileac IELs in the 60-mg/kg group at 28 days of age and in the 45-mg/kg group at 42 days of age. Meanwhile, the ileac IL-2, IL-6 contents were decreased (P < 0.05 or P < 0.01) in the 60-mg/kg group from 14 to 42 days of age and in the 45-mg/kg group from 28 to 42 days of age in comparison with those of the control group. It was concluded that dietary vanadium in excess of 30 mg/kg reduced the ileac T cell population and percentages of T cell subsets, and IL-2, IL-6, and IFN-γ contents, implying that the immune function of local intestinal mucosa in broilers could be affected by the dietary vanadium.
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Affiliation(s)
- Kangping Wang
- Key Laboratory of Animal Diseases and Environmental Hazards of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Ya'an, Sichuan, China
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Barnes BH, Tucker RM, Wehrmann F, Mack DG, Ueno Y, Mack CL. Cholangiocytes as immune modulators in rotavirus-induced murine biliary atresia. Liver Int 2009; 29:1253-61. [PMID: 19040538 PMCID: PMC3783657 DOI: 10.1111/j.1478-3231.2008.01921.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND/AIMS Biliary atresia (BA) is a progressive disease characterized by bile duct inflammation and fibrosis. The aetiology is unknown and may be due to a virus-induced, autoimmune-mediated injury of cholangiocytes. Cholangiocytes are not only targets of injury but may also modulate hepatic inflammation. The aim of this study was to determine the immune profile of murine cholangiocytes and the ability to function as antigen-presenting cells (APCs) in culture with Rhesus rotavirus (RRV), poly I:C (viral mimic) or interferon-gamma/tumour necrosis factor-alpha. METHODS/RESULTS Both the cholangiocyte cell line (long-term culture) and fresh, ex vivo cholangiocytes expressed APC surface markers major histocompatibility complex (MHC)-class I and II and CD40, while only the cultured cell line expressed costimulatory molecules B7-1 and B7-2. Despite APC expression, cultured cholangiocytes were unable to function as competent APCs in T-cell proliferation assays. Furthermore, both cultured and ex vivo cholangiocytes expressed RNA transcripts for many pro-inflammatory cytokines and chemokines. CONCLUSIONS Although cholangiocytes contain APC molecules, they are incompetent at antigen presentation and cannot elicit effective T-cell activation. Upregulation of MHC-class I and II found in BA mice may serve to prime the cholangiocyte as a target for immune-mediated injury. Cholangiocytes produced many pro-inflammatory cytokines and chemokines in the setting of RRV infection and T-helper type 1 cytokine milieu, suggesting a role of cholangiocytes as immune modulators promoting the ongoing inflammation that exists in RRV-induced BA.
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Affiliation(s)
- Barrett H. Barnes
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology & Nutrition, The Children's Hospital, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - Rebecca M. Tucker
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - Fabian Wehrmann
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology & Nutrition, The Children's Hospital, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - Doug G. Mack
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - Yoshiyuki Ueno
- Department of Medicine, Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Cara L. Mack
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology & Nutrition, The Children's Hospital, University of Colorado Denver School of Medicine, Aurora, CO, USA, Department of Medicine, Division of Allergy and Clinical Immunology, University of Colorado Denver School of Medicine, Aurora, CO, USA
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Kotb MA. Review of historical cohort: ursodeoxycholic acid in extrahepatic biliary atresia. J Pediatr Surg 2008; 43:1321-7. [PMID: 18639689 DOI: 10.1016/j.jpedsurg.2007.11.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2007] [Revised: 11/29/2007] [Accepted: 11/30/2007] [Indexed: 12/28/2022]
Abstract
BACKGROUND Ursodeoxycholic acid is a bile acid that was found to increase bile flow, protect hepatocytes, and dissolve gallstones. PURPOSE The objective of this study is to review ursodeoxycholic acid in infants and children with extrahepatic biliary atresia. METHODS We used a statistical analysis of data of records of infants and children having extrahepatic biliary atresia who underwent Kasai portoenterostomy and attended Hepatology Clinic, New Children's Hospital, Cairo University, Egypt, from May 1985 until June 2005. RESULTS Of 141 infants with extrahepatic biliary atresia, 108 received ursodeoxycholic acid for mean duration +/- SD of 252.6 +/- 544.9 days in a dosage of 20 mg/kg per day. The outcome of infants who did not receive ursodeoxycholic acid and those who did was the following: 8 (24.2%) and 11 (10.18%) had a successful outcome (P = .043), 0 (0%) and 7 (6.4%) improved (P = .148), 25 (75.7%) and 84 (77.7%) had a failed outcome (P = .489), and none vs 5 died (4.6%) (P = .135), respectively. The predictors of successful outcomes were age less than 65 days at portoenterostomy (P = .008) and absence of ursodeoxycholic acid intake (P = .04) with a likelihood of a successful outcome that was 2.8, that associated with ursodeoxycholic acid intake. CONCLUSION In this cohort of infants with extrahepatic biliary atresia, ursodeoxycholic acid was not shown to be effective, and its use was associated with a plethora of hepatic and extrahepatic complications.
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Affiliation(s)
- Magd A Kotb
- Department of Pediatrics, Cairo University, PO Box, 85 El Mokatam, Cairo 11571, Egypt.
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Lee CW, Lin MY, Lee WC, Chou MH, Hsieh CS, Lee SY, Chuang JH. Characterization of plasma proteome in biliary atresia. Clin Chim Acta 2007; 375:104-9. [PMID: 16875682 DOI: 10.1016/j.cca.2006.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2006] [Revised: 06/16/2006] [Accepted: 06/16/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND Biliary atresia (BA) is a disorder during infancy with unknown etiology in which progression frequently leads to liver cirrhosis. Plasma proteome is characterized in this study. METHODS Twelve paired plasma samples from 6 children with BA who received surgical correction at early stage and then liver transplantation at late stage of liver cirrhosis were studied. Plasma samples from 2 subjects without liver disorder were used as normal reference for 2-dimensional gel electrophoresis and for identification of protein spots by mass spectrometric analysis. Plasma samples from another 3 normal subjects (with a total of 5) were used for nephelometric quantification of immunoglobulin kappa light chain in comparison with patients' samples. RESULTS Among the protein spots detected, ranging from 6 to 200 kDa mass with pIs of 3-10, significant up-regulation of immunoglobulin kappa light chain was found at the late stage of BA, which was subsequently confirmed by nephelometric analysis. Conversely, significant decrease of apolipoprotein (Apo) A-I and C-II, haptoglobin alpha2 and beta chain, and transthyretin were detected during the progression of BA. CONCLUSIONS Increased immunoglobulin kappa light chain detected in late-stage BA characterizes adverse immune modulation in this disorder. Decreased apolipoproteins, haptoglobin and transthyretin levels might be potential markers of progressive liver injury, fibrosis and defective lipid metabolism in BA.
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Affiliation(s)
- Chi Wei Lee
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taiwan
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