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Abstract
BA is a progressive fibro-obliterative disease of the extrahepatic biliary tree that presents with biliary obstruction before two months of age. If left untreated, it presents with liver cirrhosis, ascites and hepatic failure within the first year of life The etiology of BA remains unknown. It may result from a multiple hit phenomenon in which a viral or toxic insult to the biliary epithelium leads to newly expressed antigens on the surface of bile duct epithelia, which are recognized by circulating T-lymphocytes that elicit a cellular immune response causing bile duct epithelial injury, inflammation, and fibrosis of the extrahepatic bile duct. Bile duct epithelial cells have been proposed to function as antigen presenting cells (APCs) in BA. It expresses ICAMs, which are involved in adhesion of APCs with T cells Adhesion molecules are known to be important in a variety of interactions between immunocompetent cells, connective tissue cells and extracellular matrix components. Soluble forms of various cell adhesion molecules, may be related to disease activity in various diseases ICAM-1 is a cell surface glycoprotein, expressed by several cell types including leukocytes and endothelial cells. The cellular source of ICAM-1 in biliary atresia is probably multifactorial. Since ICAM-1 expression in biliary atresia has been shown to occur not only on ductal epithelium but also on