Journal of pediatric surgery · 2005
Immune-mediated liver injury: prognostic value of CD4+, CD8+, and CD68+ in infants with extrahepatic biliary atresia.
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Kotb Magd A, El Henawy Ahmed, Talaat Sahaar, Aziz Mona, El Tagy Gamal H, El Barbary Mohamed M, Mostafa Wael
Аннотация
BACKGROUND: Hepatic fibrosis and cirrhosis develop progressively in extrahepatic biliary atresia (EHBA) despite timely surgical intervention.
PURPOSE: The aim of the study was to define CD4+ helper T lymphocytes, cytotoxic CD8+ T lymphocytes, and CD68+ (macrophages) infiltration of portal tracts and lobules and hepatic fibrosis as possible predictive measures of outcome of infants having EHBA.
METHODS: The outcome of 32 infants with EHBA was correlated to their percutaneous biopsy and postportoenterostomy core liver tissue infiltration by CD4+, CD68+, and CD8+ cells and to the degree of detected fibrosis.
RESULTS: Portoenterostomy cores were heavily infiltrated by CD4+, CD8+, and CD68+, compared with the preoperative liver biopsy (P = .008, .004, and .017, respectively). Infants having favorable outcome had more macrophage infiltration in portoenterostomy core compared with those having an unfavorable outcome (25.66 +/- 29.77 per HPF compared with 11.62 +/- 4.58, P = .000). Mean CD4+/CD8+ ratio was 1.54 +/- 1.37 in those who died within 18 months postoperatively and 0.733 +/- 0.48 in others (P = .021).
CONCLUSION: Immune-mediated destruction of portal tracts is an integral part of pathogenesis of EHBA.
PURPOSE: The aim of the study was to define CD4+ helper T lymphocytes, cytotoxic CD8+ T lymphocytes, and CD68+ (macrophages) infiltration of portal tracts and lobules and hepatic fibrosis as possible predictive measures of outcome of infants having EHBA.
METHODS: The outcome of 32 infants with EHBA was correlated to their percutaneous biopsy and postportoenterostomy core liver tissue infiltration by CD4+, CD68+, and CD8+ cells and to the degree of detected fibrosis.
RESULTS: Portoenterostomy cores were heavily infiltrated by CD4+, CD8+, and CD68+, compared with the preoperative liver biopsy (P = .008, .004, and .017, respectively). Infants having favorable outcome had more macrophage infiltration in portoenterostomy core compared with those having an unfavorable outcome (25.66 +/- 29.77 per HPF compared with 11.62 +/- 4.58, P = .000). Mean CD4+/CD8+ ratio was 1.54 +/- 1.37 in those who died within 18 months postoperatively and 0.733 +/- 0.48 in others (P = .021).
CONCLUSION: Immune-mediated destruction of portal tracts is an integral part of pathogenesis of EHBA.
Предметные рубрики MeSH
Analysis of VarianceAntigens, CDAntigens, Differentiation, MyelomonocyticBile Ducts, ExtrahepaticBiliary AtresiaCD4 AntigensCD8 AntigensFemaleHumansImmunohistochemistryInfantInfant, NewbornLiverLiver Cirrhosis, BiliaryLymphocyte CountMacrophagesMalePortal SystemPortoenterostomy, HepaticPrognosisStatistics, NonparametricT-Lymphocytes, CytotoxicT-Lymphocytes, Helper-InducerTreatment OutcomeCD68 Molecule