Purpose: The aim of this study was to compare the in situ expression of CD1
4 between early and late stage of biliary atresia (BA) to determine if a ti
me course of CD14 expression exists in BA.
Methods: Immunohistochemical analysis of membrane-bound CD14 expression was
carried out in periodate-lysine-paraformaldehyde (PLP)-fixed frozen sectio
ns from 9 early- (obtained during Kasai procedure) and 6 late- (obtained du
ring liver transplantation) stage cases of BA, Normal liver (n = 3) and cho
ledochal cysts (n = 5) served as normal controls and disease controls respe
ctively.
Results: In the early stage, 6 patients (66.66%) showed extensive CD14 expr
ession (grade 3 [G(3)], more than 50% positive cells), whereas no CD14-posi
tive cells could be detected in 4 patients (66.66%) in the late stage. In b
oth stages, most of the positive cells were observed in the parenchyma of t
he hepatic lobules where Kupffer cells and sinusoidal endothelial cells sta
ined positive. Arterial and venous endothelium, bile duct cells, and hepato
cytes were negative for CD14, Double immunohistochemistry in the early stag
e showed a higher colocalization rate of CD14 and CD68 in the sinusoidal lo
cations (33.69 +/- 9.270% [mean +/- SEM]) than in the portal tract (7.6 +/-
4.64% [mean +/- SEM]; P < .05). Similar pattern of colocalization also was
observed in the late stage. In the normal controls no expression of CD14 c
ould be detected, whereas in the disease controls only 1 case showed mild e
xpression (grade 1 [G(1)], 1% to 10% positive cells) and the rest showed no
expression of CD14.
Conclusion: These results suggest that CD14 expression in BA is a dynamic p
henomenon having time-related change with overexpression in the early stage
and reduced expression in the late stage. J Pediatr Surg 36:240-243, Copyr
ight (C) 2001 by W.B. Saunders Company.