Honsawek Sittisak, Vejchapipat Paisarn, Chongsrisawat Voranush, Thawornsuk Nutchanart, Poovorawan Yong
Department of Biochemistry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Rama IV Road, Patumwan, Bangkok, Thailand.
Pediatr Surg Int. 2011 Mar;27(3):283-8. doi: 10.1007/s00383-010-2799-7. Epub 2010 Nov 3.
Biliary atresia (BA) is one of the most serious liver disorders in children. The aims of the present study were to investigate circulating levels of osteopontin in BA children compared with healthy controls and to evaluate the relationship between circulating osteopontin and therapeutic outcome of BA patients.
Fifty-nine BA patients post-Kasai operation and 13 healthy children were recruited. The patients were divided into two groups according to their serum total bilirubin levels (TB < 2, jaundice-free vs. TB ≥ 2 mg/dL, persistent jaundice) and alanine aminotransferase (ALT < 45, normal ALT vs. ALT ≥ 45 IU/L, elevated ALT). Plasma osteopontin levels were analyzed using commercial enzyme-linked immunosorbent assay.
The circulating osteopontin was higher in BA children compared with that of healthy controls (146.9 ± 19.1 vs. 28.0 ± 8.4 ng/mL, P = 0.001). The BA patients with persistent jaundice had more increased plasma osteopontin levels than those without jaundice (157.8 ± 47.9 vs. 27.5 ± 6.4 ng/mL, P = 0.001). Furthermore, plasma osteopontin levels in BA patients with elevated ALT were significantly higher than those with normal ALT (103.2 ± 29.2 vs. 24.5 ± 7.9 ng/mL, P = 0.01). In addition, circulating osteopontin was positively correlated with serum total bilirubin (r = 0.526, P < 0.001) and with serum ALT (r = 0.575, P < 0.001). Subsequent analysis showed that the BA patients with portal hypertension had more elevated plasma osteopontin compared to those without portal hypertension (116.7 ± 31.1 vs. 19.5 ± 9.3 ng/mL, P = 0.01).
Increased circulating osteopontin was associated with the development of hepatic dysfunction and portal hypertension in BA patients. Circulating osteopontin may serve as a possible marker reflecting disease severity and monitoring the disease progression in postoperative BA patients.
胆道闭锁（BA）是儿童最严重的肝脏疾病之一。本研究旨在调查BA患儿与健康对照者相比骨桥蛋白的循环水平，并评估循环骨桥蛋白与BA患者治疗结果之间的关系。
招募了59例接受葛西手术后的BA患者和13名健康儿童。根据血清总胆红素水平（TB＜2，无黄疸与TB≥2mg/dL，持续性黄疸）和丙氨酸转氨酶（ALT＜45，ALT正常与ALT≥45IU/L，ALT升高）将患者分为两组。使用商业酶联免疫吸附测定法分析血浆骨桥蛋白水平。
BA患儿的循环骨桥蛋白水平高于健康对照者（146.9±19.1对28.0±8.4ng/mL，P=0.001）。持续性黄疸的BA患者血浆骨桥蛋白水平升高幅度大于无黄疸患者（157.8±47.9对27.5±6.4ng/mL，P=0.001）。此外，ALT升高的BA患者血浆骨桥蛋白水平显著高于ALT正常的患者（103.2±29.2对24.5±7.9ng/mL，P=0.01）。另外，循环骨桥蛋白与血清总胆红素呈正相关（r=0.526，P＜0.001），与血清ALT呈正相关（r=0.575，P＜0.001）。后续分析显示，有门静脉高压的BA患者血浆骨桥蛋白水平高于无门静脉高压的患者（116.7±31.1对19.5±9.3ng/mL，P=0.01）。
循环骨桥蛋白升高与BA患者肝功能障碍和门静脉高压的发生有关。循环骨桥蛋白可能作为反映疾病严重程度和监测术后BA患者疾病进展的潜在标志物。
