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Immunohistochemical study of the stem cell marker Foxl1 in bile ductular proliferation and liver cell regeneration in liver biopsies from infants with cholestasis
Joint Event on 13th International Conference on Pediatric Gastroenterology Hepatology & Nutrition & 3rd International Conference on Digestive and Metabolic Diseases
Liver cell regeneration takes place through mature hepatocytes. However, in cases of chronic or severe injury, an alternative
pathway takes place through proliferation of hepatic progenitor cells (HPCs). The aim of the study was to investigate
the distribution and number of Foxl1 positive HPCs in the liver of infants with different cholestatic diseases. Therefore,
immunohistochemistry using Foxl1 antibody (ab190226) was conducted on 53 formalin fixed paraffin embedded blocks of
liver biopsies from infants with neonatal cholestasis with the following diagnoses: 30 cases of extra hepatic biliary atresia
(EHBA), 11 cases of paucity of intrahepatic bile ducts (PIBD), eight cases of idiopathic neonatal giant cell hepatitis (NGCH)
and four cases of galactosemia. Trichrome staining was done to assess the stage of fibrosis according to a previously published
modified scoring system. Foxl1 positive cells were seen in the periportal area and their numbers were much higher in liver
biopsies obtained from infants with EHBA compared to the other diagnoses. Significant positive correlations were found
between the number of HPCs and stage of fibrosis, degree of ductular proliferation, the presence of portal tract neutrophils
as well as higher levels of serum gamma glutamyl transferase. In conclusion, HPCs are markedly activated in EHBA and
their activation might be the reason for the associated ductular proliferation and fibrosis. However, the type of inflammatory
infiltrate might play a role in HPCs activation as well. This may help to guide further research on animal models to design
HPC-based anti-fibrotic therapies for cholestatic liver diseases.
Biography
Basma Elhaddad is a Faculty Member (Demonstrator) at the Pathology Department, Faculty of Medicine, Alexandria University, Egypt. She graduated from the Faculty of Medicine, Alexandria University in 2010 (MBBCh).She is pursuing Master’s Degree student with a thesis in the Pathology of Gastrointestinal tract and liver “Master of Basic Medical Sciences in Pathology (MSc.); GPA: Excellent with Honour”