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Yang J, Chen X, Wang W, Su Y, Liu K, Abudusalamu A, Li D, He Y, Wang P, Xiong X, Feng J. Role of cholinergic innervation in biliary remnants of patients with biliary atresia. Front Pediatr 2024; 11:1278978. [PMID: 38259596 PMCID: PMC10800818 DOI: 10.3389/fped.2023.1278978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024] Open
Abstract
Objective Biliary innervation is considered important in regulating the function of bile ducts, whereas the role of innervation in the hepatobiliary system of patients with biliary atresia (BA) remains unknown. This current study aims to investigate the role of innervation in biliary remnants and analyze the relationship between the innervation and prognosis of BA after surgery. Methods Eighty-seven patients with type III BA who underwent the Kasai procedure were consecutively enrolled from January 2017 to September 2020. Innervation and ductules in remnants were examined by pathologists. Liver function, onset of cholangitis, jaundice clearance, and survival with the native liver were recorded. Patients were followed up for 24 months. The relationship between innervation and prognosis was analyzed. Results In total, 67 patients had bile drainage postoperatively, and 21 biliary remnants contained neuronal plexuses where there was no neuron but nerve fiber bundles. Acetylcholinesterase staining was positive in all plexuses. In patients with bile drainage, those with plexuses had improved postoperative liver function, significantly better jaundice clearance 3 or 6 months postoperatively (50.0% vs. 19.1%, or 90.0% vs. 63.8%, respectively), fewer episodes of early cholangitis (10.0% vs. 34.0%), and better survival (80.0% vs. 61.7%) compared to those without. In addition, a larger area of plexuses was associated with a larger area of ductules (R2 = 0.786, p = 0.000), less frequent (p = 0.000) and later cholangitis onset (p = 0.012), and better jaundice clearance (p = 0.063). Conclusions Increased cholinergic innervation in biliary remnants may help reduce the onset of cholangitis and lead to better and earlier jaundice clearance. Thus, it improves the postoperative prognosis of patients with BA.
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Affiliation(s)
- Jixin Yang
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiaoqing Chen
- Department of Pediatric Surgery, Jiangxi Provincial Children’s Hospital, Nanchang, Jiangxi, China
| | - Wenjing Wang
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yanwei Su
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Keqin Liu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Adila Abudusalamu
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Dandan Li
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Ying He
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Pusu Wang
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiaofeng Xiong
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Jiexiong Feng
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Zanchi A, Reidy J, Feldman HJ, Qualter J, Gouw AS, Osbeck J, Kofman A, Balabaud C, Bioulac-Sage P, Tiniakos DG, Theise ND. Innervation of the proximal human biliary tree. Virchows Arch 2020; 477:385-392. [DOI: 10.1007/s00428-020-02761-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/06/2020] [Accepted: 01/21/2020] [Indexed: 01/03/2023]
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Xia X, Jung D, Webb P, Zhang A, Zhang B, Li L, Ayers SD, Gabbi C, Ueno Y, Gustafsson JÅ, Alpini G, Moore DD, LeSage GD. Liver X receptor β and peroxisome proliferator-activated receptor δ regulate cholesterol transport in murine cholangiocytes. Hepatology 2012; 56:2288-96. [PMID: 22729460 PMCID: PMC3469731 DOI: 10.1002/hep.25919] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 06/03/2012] [Indexed: 02/02/2023]
Abstract
UNLABELLED Nuclear receptors (NRs) play crucial roles in the regulation of hepatic cholesterol synthesis, metabolism, and conversion to bile acids, but their actions in cholangiocytes have not been examined. In this study, we investigated the roles of NRs in cholangiocyte physiology and cholesterol metabolism and flux. We examined the expression of NRs and other genes involved in cholesterol homeostasis in freshly isolated and cultured murine cholangiocytes and found that these cells express a specific subset of NRs, including liver X receptor (LXR) β and peroxisome proliferator-activated receptor (PPAR) δ. Activation of LXRβ and/or PPARδ in cholangiocytes induces ATP-binding cassette cholesterol transporter A1 (ABCA1) and increases cholesterol export at the basolateral compartment in polarized cultured cholangiocytes. In addition, PPARδ induces Niemann-Pick C1-like L1 (NPC1L1), which imports cholesterol into cholangiocytes and is expressed on the apical cholangiocyte membrane via specific interaction with a peroxisome proliferator-activated response element (PPRE) within the NPC1L1 promoter. CONCLUSION We propose that (1) LXRβ and PPARδ coordinate NPC1L1/ABCA1-dependent vectorial cholesterol flux from bile through cholangiocytes and (2) manipulation of these processes may influence bile composition with important applications in cholestatic liver disease and gallstone disease, two serious health concerns for humans.
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Affiliation(s)
- Xuefeng Xia
- Methodist Hospital Research Institute, Weill Cornell School of Medicine, Houston, TX 77030, USA.
| | - Dongju Jung
- Department of Molecular and Cellular Biology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030
| | - Paul Webb
- The Methodist Hospital Research Institute, Weill Cornell School of Medicine, 6670 Bertner Ave, Houston, TX 77030
| | - Aijun Zhang
- The Methodist Hospital Research Institute, Weill Cornell School of Medicine, 6670 Bertner Ave, Houston, TX 77030
| | - Bin Zhang
- The Methodist Hospital Research Institute, Weill Cornell School of Medicine, 6670 Bertner Ave, Houston, TX 77030
| | - Lifei Li
- The First Hospital, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Stephen D. Ayers
- The Methodist Hospital Research Institute, Weill Cornell School of Medicine, 6670 Bertner Ave, Houston, TX 77030
| | - Chiara Gabbi
- Center for Nuclear Receptor and Cell Signaling, University of Houston, Calhoun Road, Houston TX77004,Karolinska Institutet, Department of Biosciences and Nutrition, NOVUM, 14186 Stockholm, Sweden
| | - Yoshiyuki Ueno
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jan-Åke Gustafsson
- Center for Nuclear Receptor and Cell Signaling, University of Houston, Calhoun Road, Houston TX77004,Karolinska Institutet, Department of Biosciences and Nutrition, NOVUM, 14186 Stockholm, Sweden
| | - Gianfranco Alpini
- Scott & White Digestive Diseases Research Center, Temple, TX 76504,Division Research, Central Texas Veterans Health Care System, Temple, TX 76504,Department of Medicine, Texas A & M Health Science Center College of Medicine, Temple, TX 76504
| | - David D. Moore
- Department of Molecular and Cellular Biology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030
| | - Gene D. LeSage
- Department of Internal Medicine at East Tennessee State University’s James H. Quillen College of Medicine, Johnson City, TN 37614,Correspondence to: Xuefeng Xia, The Methodist Hospital Research Institute, 6670 Bertner Ave, R8-117, Houston, TX 77030, Telephone: 713-441-6665, Fax: 713-793-7162, and Gene LeSage, Department of Internal Medicine, East Tennessee State University, VA Bldg. 1, Box 70622, Johnson City, TN 37614, Telephone: 423-439-6282, Fax: 423-439-6387,
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Alpini G, Ueno Y, Tadlock L, Glaser SS, LeSage G, Francis H, Taffetani S, Marzioni M, Alvaro D, Patel T. Increased susceptibility of cholangiocytes to tumor necrosis factor-alpha cytotoxicity after bile duct ligation. Am J Physiol Cell Physiol 2003; 285:C183-94. [PMID: 12637265 DOI: 10.1152/ajpcell.00497.2002] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Tumor necrosis factor (TNF)-alpha plays a critical role in epithelial cell injury. However, the role of TNF-alpha in mediating cholangiocyte injury under physiological or pathophysiological conditions is unknown. Thus we assessed the effects of TNF-alpha alone or following sensitization by actinomycin D on cell apoptosis, proliferation, and basal and secretin-stimulated ductal secretion in cholangiocytes from normal or bile duct-ligated (BDL) rats. Cholangiocytes from normal or BDL rats were highly resistant to TNF-alpha alone. However, presensitization by actinomycin D increased apoptosis in cholangiocytes following BDL and was associated with an inhibition of proliferation and secretin-stimulated ductal secretion. Thus TNF-alpha mediates cholangiocyte injury and altered ductal secretion following bile duct ligation. These observations suggest that cholestasis may enhance susceptibility to cytokine-mediated cholangiocyte injury.
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Affiliation(s)
- Gianfranco Alpini
- Department of Internal Medicine, Texas A&M University System Health Science Center, College of Medicine, Temple, TX 76502, USA
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