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

Abstract

BackgroundPostoperative cholangitis is a common but severe complication after Kasai portoenterostomy for biliary atresia (BA). This study aimed to identify its prognostic factors.MethodsTwo 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.ResultsCholangitis 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.ConclusionOur 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.

Early bile drainage improves native liver survival in biliary atresia without cholangitis

“…Cholangitis not only seriously affects the quality of life of BA children after KPE but also places great economic and psychological burdens on their parents ( 13 ). The effect of cholangitis on NLS is controversial.…”

“…Cholangitis was defined as the presence of systemic inflammation (fever ≥38.0°C or elevated inflammatory markers, such as the white blood cell [WBC] count and C-reactive protein [CRP] level), with evidence of cholestasis (jaundice aggravates or regresses, stool color becomes lighter or acholic stool reappears, serum total bilirubin and direct bilirubin increases) ( 11 , 12 ). To better explore the relationship between cholangitis and NLS, cholangitis occurring within 1 month after KPE was defined as early cholangitis, and cholangitis occurring 1 month after KPE was defined as late cholangitis ( 6 , 13 ). A frequency of cholangitis ≤3 times within 6 months after KPE was considered to be occasional cholangitis, and a frequency of >3 times was considered to be recurrent cholangitis.…”

Comprehensive Analysis of Gut Microbiota and Fecal Bile Acid Profiles in Children With Biliary Atresia

“…Cholangitis is the most common complication in patients with BA after Kasai surgery, with an incidence of 30%-70% (Gunadi et al, 2018). Several studies have suggested that cholangitis may be a risk factor for poor prognosis in patients with post-Kasai BA (Jiang et al, 2018). Cholangitis can lead to increased cholestasis and accelerated liver injury.…”

Alterations of gut microbiota in infants with biliary atresia identified by 16S rRNA-sequencing

“…Biliary atresia (BA) is a rare but life-threatening neonatal disease [ 1 ]. BA is characterized by progressive intra- and extra-hepatic bile duct inflammation and liver fibrosis, which eventually develops into liver cirrhosis and liver failure [ 2 ].…”