Expression of programmed death-1 and its ligands in the liver of biliary atresia.
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.
Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, No. 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China.
Pan-Liang
PL
Wang
Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, No. 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China.
Jun
J
Wang
Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, No. 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China.
Ying
Y
Zhou
Department of Transplantation and Hepatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Xiao-Song
XS
Chen
Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.
Ke-Jun
KJ
Zhou
Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.
Jie
J
Wen
Department of Transplantation and Hepatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Jian-Jun
JJ
Zhang
Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, No. 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China. caiw1978@163.com.|Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. caiw1978@163.com.|Shanghai Institute of Pediatric Research, Shanghai, China. caiw1978@163.com.
Wei
W
Cai
D060890:B7-H1 Antigen / Q000235:genetics*; D001656:Biliary Atresia / Q000235:genetics* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D001707:Biopsy, Needle; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002681:China; D005260:Female; D005500:Follow-Up Studies; D018507:Gene Expression Regulation, Developmental; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate
D060890:B7-H1 Antigen; C423236:CD274 protein, human
biliary atresia; immunostaining; liver; neonatal hepatitis syndrome; programmed death-1