BACKGROUND AND AIMSBiliary atresia is a fibrosing cholangiopathy affecting neonates that is thought to result from a prenatal environmental insult to the bile duct. Biliatresone, a plant toxin with an α-methylene ketone group, was previously implicated in biliary atresia in Australian livestock, but is found in a limited location and is highly unlikely to be a significant human toxin. We hypothesized that other unsaturated carbonyl compounds, some with the potential for significant human exposure, might also be biliary toxins. METHODSWe focused on the family of microcystins, cyclic peptide toxins from blue-green algae that are found worldwide, particularly during harmful algal blooms. We used primary extrahepatic cholangiocyte spheroids and extrahepatic bile duct explants from both neonatal (a total of 86 P2 mouse pups and 18 P2 rat pups (n=8-10 per condition for both species)) and adult rodents (a total of 31 P15-18 mice (n=10-11 per condition)) to study the biliary toxicity of microcystins and potential mechanisms RESULTSWe found that 400 nM microcystin-RR, but not six other microcystins or the related algal toxin nodularin, caused greater than 80% lumen closure in cell spheroids made from extrahepatic cholangiocytes isolated from 2-3-day-old mice (p<0.0001). In contrast, it resulted in less than an average of 5% lumen closure in spheroids derived from neonatal intrahepatic cholangiocytes or cells from adult mice (p=0.4366). We also found that microcystin-RR caused occlusion of extrahepatic bile duct explants from 2-day-old mice (p<0.0001), but not 18-day-old mice. Microcystin-RR caused a 2.3 times increase in reactive oxygen species in neonatal cholangiocytes (p<0.0001), and treatment with N-acetyl cysteine partially prevented microcystin-RR-induced lumen closure (p=0.0004), suggesting a role for redox homeostasis in its mechanism of action. CONCLUSIONSWe identify microcystin-RR as a selective neonatal extrahepatic cholangiocyte toxin and suggest that it acts by increasing redox stress.