Biliary atresia (BA) is the most common indication for liver transplantation among children globally. BA is a phenotype and a lot of studies have shed light on its possible etiology. Irrespective of etiology, following induction of inflammation within the walls of the biliary system, the inflammatory process leads to adhesions and obliteration of biliary radicals. Accelerated cirrhosis is another constant feature of BA.
Many factors have been flagged as the initial inciter of bile duct wall inflammation: these include viral, vascular, immune, toxins as biliatresone, and other alkaloids. The perinatal aflatoxin-induced cholangiopathy in GST M1 deficient Egyptian neonates born to GST M1 heterozygous mothers (The Kotb disease) is a BA variant. Neonatal screening for BA by stool card, and by measurement of conjugated bilirubin has been associated with a reduction in late referrals, younger age at portoenterostomy and a significant increment of the 5-year jaundice-free survival rate with native liver.
Now that we know that perinatal passage of aflatoxins through milking of the cord, results in BA in the GST M1 deficient neonate, we realize that BA can be a preventable disease.
In this Research Topic we aim to explore questions such as:
- How much do we know about the prevalence of aflatoxin-induced cholangiopathy world-wide?
- Would screening for GST M1 among pregnant women allow the early detection of those susceptible to this BA variant?
- Would stopping milking of cord in neonates with GST M1 mutations be enough?
- How much do we know about BA etiology in different countries of the world?
- Are there other BA-inducing agents transmitted perinatally during milking of the cord?
- Are antiviral treatments effective in controlling the march of BA?
- What are the most promising adjuvant therapies to prevent or delay cirrhosis?
- Is it possible to chelate aflatoxins in infants with BA?
- Is there a role for immune-suppressive medications beyond steroids?
We welcome all insights and types of manuscripts that address BA susceptibility, etiology, screening, management, natural history, treatment, transplantation challenges, outcome, burden, prevention and elimination.
Biliary atresia (BA) is the most common indication for liver transplantation among children globally. BA is a phenotype and a lot of studies have shed light on its possible etiology. Irrespective of etiology, following induction of inflammation within the walls of the biliary system, the inflammatory process leads to adhesions and obliteration of biliary radicals. Accelerated cirrhosis is another constant feature of BA.
Many factors have been flagged as the initial inciter of bile duct wall inflammation: these include viral, vascular, immune, toxins as biliatresone, and other alkaloids. The perinatal aflatoxin-induced cholangiopathy in GST M1 deficient Egyptian neonates born to GST M1 heterozygous mothers (The Kotb disease) is a BA variant. Neonatal screening for BA by stool card, and by measurement of conjugated bilirubin has been associated with a reduction in late referrals, younger age at portoenterostomy and a significant increment of the 5-year jaundice-free survival rate with native liver.
Now that we know that perinatal passage of aflatoxins through milking of the cord, results in BA in the GST M1 deficient neonate, we realize that BA can be a preventable disease.
In this Research Topic we aim to explore questions such as:
- How much do we know about the prevalence of aflatoxin-induced cholangiopathy world-wide?
- Would screening for GST M1 among pregnant women allow the early detection of those susceptible to this BA variant?
- Would stopping milking of cord in neonates with GST M1 mutations be enough?
- How much do we know about BA etiology in different countries of the world?
- Are there other BA-inducing agents transmitted perinatally during milking of the cord?
- Are antiviral treatments effective in controlling the march of BA?
- What are the most promising adjuvant therapies to prevent or delay cirrhosis?
- Is it possible to chelate aflatoxins in infants with BA?
- Is there a role for immune-suppressive medications beyond steroids?
We welcome all insights and types of manuscripts that address BA susceptibility, etiology, screening, management, natural history, treatment, transplantation challenges, outcome, burden, prevention and elimination.