Comparison of CD4+/Foxp3+ and CD4+/IL-17+ cells counts on cholestatic infants with and without biliary atresia

INTRODUCTION: Biliary atresia (BA) is a progressive obstructive cholangiopathy with high mortality which is caused by immune system dysregulation and multiple hit mechanism that involves T-reg cells (represented by CD4+/FoxP3+ cells) and Th17 (CD4+/IL-17+). This study aims to compare CD4+/FoxP3+ and CD4+/IL-17+ cells counts on cholestasis infants with and without BA. METHODS: liver biopsies of cholestasis infants which are range of age 1 -12 months old hospitalized in Pediatric Ward of Dr. Soetomo General Hospital, Surabaya for a period of 6 months. Hematoxyllin-eosine (HE) staining was performed for diagnosing of BA. Immunohistochemistry (IHC) staining was done for counting of CD4+/FoxP3+ and CD4+/IL-17+ cells. RESULTS: a total of 34 samples in this study, 20 infants with BA and 14 without BA. The number of CD4+/FoxP3+ cells on BA group is fewer than non-BA group (median: 6 vs. 14 cells/high power field (hpf); p<0,001). The number of CD4+/IL-17+ cells on BA group higher than non-BA group (median: 7 vs. 5 cell/hpf; p=0,04). CONCLUSION: the number of CD4+/FoxP3+ cells is fewer, while number of CD4+/IL-17+ is higher on cholestasis infants with BA compared to without BA.