Association of Autophagy-Related Gene 5 (ATG5) With Neonatal Cholestasis in Egyptian Pediatric Patients.

Background & Objective: Neonatal cholestasis (NC) occurs in approximately 1 in 2500 live births. Autophagy-related gene 5 (ATG5) is a central component of the autophagy machinery, particularly in autophagosome formation. The autophagic process regulated by ATG5 has been implicated in various physiological and pathological conditions. This study aimed to evaluate the role of ATG5 in NC. Methods: This retrospective study analyzed liver biopsies from 74 patients with NC. 46 with extrahepatic etiology and 28 with intrahepatic etiology. Immunohistochemical expression of ATG5 was assessed in hepatocytes and biliary epithelium. Results: A significant association was observed between intrahepatic cholestasis and the intensity of ATG5 expression in zone II hepatocytes (P = .029). Overexpression of ATG5 in hepatocytes was significantly associated with mild portal tract fibrosis (P = .038) and mild lymphocytic infiltrates (P = .005). Conclusion: ATG5 appears to contribute to the pathogenesis of NC in Egyptian infants. These findings may provide a basis for further research into novel diagnostic and therapeutic strategies.