Bagus Setyoboedi; Hakimah Maimunah; Rendi Aji Prihaningtyas; Sjamsul Arief
Abstract
Biliary atresia (BA) is a disease characterized by a gradual inflammatory process resulting in fibrosis and total obstruction of the bile ducts. This can gradually lead to biliary cirrhosis, ...
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Biliary atresia (BA) is a disease characterized by a gradual inflammatory process resulting in fibrosis and total obstruction of the bile ducts. This can gradually lead to biliary cirrhosis, portal hypertension, liver failure, and mortality. The pathogenesis is still not fully understood. It is suggested that viral infection of the bile duct epithelium leads to cholangiocyte apoptosis, which is then followed by an immunologic response involving autoreactive T cells. This study compares CD4+, CD8+, CD4+Th1, and CD4+Th2 counts between biliary atresia and non-biliary atresia in neonatal cholestasis infants. A cross-sectional study was performed for six months. Diagnosis of biliary atresia was confirmed through percutaneous liver biopsy, along with the analysis of CD4+, CD8+, CD4+Th1, and CD4+Th2 cell counts using immunohistochemistry. Statistical analysis was performed using an Independent sample t-test, Mann-Whitney U test, and Kruskal-Wallis test. A total of 20 biliary atresias and 14 non-biliary atresias were included in this study. Specific immune cell counts were higher in the group with biliary atresia than non-biliary atresia. This difference was observed in CD4+, CD8+, CD4+ Th1, and CD4+ Th2 cells with specific counts being [16 (14-18) vs. 11.5 (9-12.25)], [10.5 (9-12) vs. 3 (2-4)], [10 (9-12.75) vs. 6 (5-7)], and [11.5 (9.5-14) vs. 2 (1-3)] respectively with p<0.05. Patients with biliary atresia showed elevated number of CD4+, CD8+, CD4+ Th1, and CD4+ Th2 cells. Clinical evidence suggests the potential involvement of these specific markers, particularly CD4+ Th2 cells, along with possible autoimmune mechanisms in the pathogenesis of biliary atresia.
