Journal
SURGERY TODAY
Volume 47, Issue 10, Pages 1282-1286Publisher
SPRINGER
DOI: 10.1007/s00595-017-1502-1
Keywords
Biliary atresia; Regulatory T cell; Lymphadenopathy; Hepatic hilar lymph nodes
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Funding
- Grants-in-Aid for Scientific Research [17K11514] Funding Source: KAKEN
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A proposed etiopathogenesis of biliary atresia (BA) involves T-cell-mediated inflammatory bile duct damage and progressive hepatic fibrosis. Pediatric surgeons often observe swelling of the hepatic hilar lymph nodes during the Kasai procedure. Given the importance of regulatory mechanisms in immune responses, the present study was designed to analyze the quantitative changes of regulatory T cells (T (reg) cells) in the hepatic hilar lymph nodes (hepatic hilar LNs) and peripheral blood (PB) in BA. The hepatic hilar LNs and PB obtained during the Kasai procedure were analyzed by flow cytometry. The ratios of total and active Tregs to the total CD4(+) cells in the PB and the hepatic hilar LNs were compared. In patients with BA, the ratios of both the total and active T (reg) cells in the hepatic hilar LNs were higher than those in the PB (total T (reg) cells: PB vs. LN; P < 0.001; active T (reg) cells: PB vs. LN; P = 0.001). In BA patients, the increase in the ratio of active T (reg) cells to the CD4 + cells in the LNs in comparison to the PB was greater than that in control patients. The ratio observed in the BA patients was almost double the ratio observed in the control patients. The median LN/PB ratio in the BA patients was 3.1, while that in controls was 1.6 (P = 0.03). The present study showed that the ratios of both total T (reg) cells and active T (reg) cells were higher in the hepatic hilar lymph nodes of BA patients. This finding could shed light on the pathogenesis of BA.
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