Preativatanyou K, Honsawek S, Chongsrisawat V, Vejchapipat P, Theamboonlers A, Poovorawan Y
Faculty of Medicine Chulalongkorn University, Parasitology, Bangkok, Thailand.
Eur J Pediatr Surg. 2010 Jul;20(4):237-41. doi: 10.1055/s-0030-1249695. Epub 2010 Apr 9.
Biliary atresia (BA) is a chronic progressive inflammatory disorder of the extrahepatic and intrahepatic biliary system in children. The aim of the present study was to investigate circulating endoglin levels in BA patients compared with healthy controls and to determine the relationship between plasma endoglin levels and outcome parameters of BA patients after Kasai operation.
Fifty-five postoperative BA patients and 14 healthy controls were recruited. The patients were divided into two groups based on their serum total bilirubin levels (TB<34.2, no jaundice vs. TB>or=34.2 micromol/L, persistent jaundice) and serum alanine aminotransferase (ALT<45, normal ALT vs. ALT>or=45 IU/L, high ALT). Circulating endoglin levels were analyzed by enzyme-linked immunosorbent assay.
Average levels of plasma endoglin were significantly higher in BA patients compared to healthy controls (7.8+/-0.4 vs. 6.5+/-0.4 ng/mL; P=0.02). BA patients with persistent jaundice had higher plasma endoglin levels than those without jaundice (9.2+/-0.8 vs. 6.9+/-0.3 ng/mL; P=0.006). Furthermore, the concentrations of plasma endoglin in BA patients with high ALT were significantly higher compared to those with normal ALT (8.5+/-0.5 vs. 6.3+/-0.5 ng/mL, P=0.003). In addition, BA patients with portal hypertension had more elevated plasma endoglin levels than those without portal hypertension (8.8+/-0.6 vs. 6.1+/-0.3 ng/mL, P=0.001). Plasma endoglin was positively correlated with serum ALT (r=0.36, P=0.007) and serum GGT (r=0.44, P=0.001).
High circulating endoglin correlated with a poor outcome for BA. Plasma endoglin can be utilized as a potential biomarker reflecting the severity of ongoing liver injury and biliary obstruction in BA patients after Kasai procedure.
胆道闭锁（BA）是一种儿童肝外和肝内胆道系统的慢性进行性炎症性疾病。本研究的目的是调查BA患者与健康对照者循环内皮糖蛋白水平，并确定血浆内皮糖蛋白水平与BA患者Kasai手术后结局参数之间的关系。
招募了55例Kasai手术后的BA患者和14名健康对照者。根据血清总胆红素水平（TB<34.2，无黄疸与TB≥34.2 μmol/L，持续性黄疸）和血清丙氨酸氨基转移酶（ALT<45，正常ALT与ALT≥45 IU/L，高ALT）将患者分为两组。通过酶联免疫吸附测定法分析循环内皮糖蛋白水平。
与健康对照者相比，BA患者血浆内皮糖蛋白的平均水平显著更高（7.8±0.4 vs. 6.5±0.4 ng/mL；P=0.02）。持续性黄疸的BA患者血浆内皮糖蛋白水平高于无黄疸患者（9.2±0.8 vs. 6.9±0.3 ng/mL；P=0.006）。此外，高ALT的BA患者血浆内皮糖蛋白浓度显著高于正常ALT患者（8.5±0.5 vs. 6.3±0.5 ng/mL，P=0.003）。另外，有门静脉高压的BA患者血浆内皮糖蛋白水平高于无门静脉高压患者（8.8±0.6 vs. 6.1±0.3 ng/mL，P=0.001）。血浆内皮糖蛋白与血清ALT呈正相关（r=0.36，P=0.007），与血清γ-谷氨酰转移酶（GGT）呈正相关（r=0.44，P=0.001）。
循环内皮糖蛋白水平升高与BA预后不良相关。血浆内皮糖蛋白可作为反映Kasai手术后BA患者持续肝损伤和胆道梗阻严重程度的潜在生物标志物。
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