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Histopathological expression of Yes-associated protein in neonatal cholestasis
Sahar Shahin Abo-Zeinah1, Behairy Behairy1, Mohsen Hasan Hussein1
1Department of Pediatric Hepatology, National Liver Institute, Menoufia University, 32511 Shebin El-koom, Menoufia, Egypt.
Insights
Yes-associated protein (YAP) is significantly elevated in biliary atresia (BA) liver tissues. YAP expression can help differentiate BA from other neonatal cholestasis causes, improving diagnosis in infants.
Area of Science:
- Pediatric Hepatology
- Gastroenterology
- Developmental Biology
Background:
- Biliary atresia (BA) is a leading cause of neonatal cholestasis and pediatric liver transplantation.
- Yes-associated protein (YAP) plays a crucial role in bile duct development and gastrointestinal adaptation.
- Neonatal cholestasis requires accurate differential diagnosis to guide timely intervention.
Purpose of the Study:
- To investigate Yes-associated protein (YAP) expression in infant liver tissues with neonatal cholestasis.
- To assess the diagnostic utility of YAP expression in differentiating biliary atresia (BA) from other cholestatic conditions.
Main Methods:
- Prospective study of 100 infants with neonatal cholestasis, divided into BA and non-BA groups (50 each).
- Inclusion of 10 healthy liver transplant donors as controls.
- Immunohistochemical staining to evaluate hepatic YAP expression, correlated with clinical and histopathological findings.
Main Results:
- YAP expression was significantly higher in the bile ductular and interlobular biliary epithelium of BA infants compared to the non-BA group (P<0.05).
- Normal liver tissue from transplant donors showed weak or no YAP expression.
- YAP immunohistochemistry demonstrated 80% sensitivity, 94% specificity, and 87% accuracy in distinguishing BA from non-BA (P<0.0001).
Conclusions:
- Hepatic YAP expression is significantly elevated in biliary atresia.
- YAP serves as a valuable biomarker for discriminating BA from other causes of neonatal cholestasis.
Background:
Biliary atresia (BA) is a common cause of persistent neonatal cholestasis and liver transplantation in the pediatric population. Yes-associated protein (YAP) has also been shown to be necessary for development of bile ducts and adaptive responses within the gastrointestinal tract. We aimed to evaluate the YAP expression in liver tissues of infants with neonatal cholestasis as well as its diagnostic potential in the differential diagnosis of BA.
Patients And Methods:
This prospective study included 100 infants with neonatal cholestasis. After full history taking, thorough clinical examination, routine investigations, and histopathological assessment, the patients were allocated as BA and non-BA; fifty patients in each group. Ten liver biopsies from 10 donors of liver transplant recipients served as controls. Diagnosis of BA was confirmed by operative cholangiography. Hepatic expression of YAP was assessed by immunohistochemical staining.
Results:
Presence of clay stool, elevated GGT and absence of gall bladder contractility were the main preliminary signs alarming for the possibility of BA. Bile ductular and interlobular biliary epithelium and hepatic lobule expression of YAP in patients with BA was significantly higher than that in Non-BA group (P<0.05). There was no or weak positive YAP expression in normal liver of transplant donors. Positive YAP immunohistochemical had a sensitivity of 80% and a specificity of 94% with accuracy 87% in discrimination between BA and non-BA group (P-value<0.0001).
Conclusion:
Hepatic expression of YAP was significantly higher in BA than in non-BA group and could discriminate BA from other causes of cholestasis.
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