Watanabe Eiichiro, Saito Takeshi, Yoshihara Masahito, Konno Ryo, Fujishiro Jun, Takazawa Shinya, Ichinose Akinori, Miyake Kazue, Kakihara Tomo, Ishimaru Tetsuya, Nishi Akira, Fukuda Akinari, Kasahara Mureo, Ohara Osamu, Kawashima Yusuke
Faculty of Medicine, Department of Pediatric Surgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan.
Gastro Hep Adv. 2025 Apr 29;4(8):100688. doi: 10.1016/j.gastha.2025.100688. eCollection 2025.
Biliary atresia (BA) is a severe neonatal condition, characterized by jaundice and hyperbilirubinemia, resulting in cholestasis. Although early diagnosis followed by Kasai portoenterostomy (KPE) can rescue patients, they are prone to complications such as cholangitis. Moreover, a comprehensive study assessing intestinal environment is currently lacking. Therefore, in this study, we aimed to elucidate the stool protein profiles of patients with BA following KPE, provide insights into the native liver condition of BA, and open new avenues for clinical approaches through stool proteome analysis.
In this prospective study, stool proteome analysis was conducted on samples from 4 patients with well-controlled conditions, 4 patients with repeated cholangitis, and 3 patients with prolonged jaundice without cholangitis, all of whom had undergone KPE. Fifteen healthy individuals without BA were included for comparison.
Principal component analysis revealed that the stool profiles of patients post-KPE with favorable outcomes closely resembled those of healthy controls, whereas the profiles of patients with unfavorable outcomes showed distinct patterns. Notably, C-reactive protein levels were elevated, whereas sodium/hydrogen exchanger 3 levels were decreased in the group with repeated cholangitis.
This study highlights distinct differences in stool protein profiles following KPE, particularly in patients with poor clinical outcomes. This suggests that stool proteome analysis has the potential to provide insights into the native liver conditions of BA patients post-KPE, reflecting their clinical status.
胆道闭锁（BA）是一种严重的新生儿疾病，其特征为黄疸和高胆红素血症，可导致胆汁淤积。尽管早期诊断并随后进行Kasai肝门空肠吻合术（KPE）可挽救患者，但他们容易出现胆管炎等并发症。此外，目前缺乏对肠道环境的全面研究。因此，在本研究中，我们旨在阐明接受KPE治疗的BA患者的粪便蛋白质谱，深入了解BA患者的肝脏原始状况，并通过粪便蛋白质组分析为临床治疗开辟新途径。
在这项前瞻性研究中，对4例病情控制良好、4例反复发生胆管炎以及3例无胆管炎但黄疸持续时间较长的接受KPE治疗的患者的样本进行了粪便蛋白质组分析。纳入15名无BA的健康个体作为对照。
主成分分析显示，KPE术后预后良好的患者粪便谱与健康对照者的粪便谱非常相似，而预后不良的患者粪便谱呈现出不同的模式。值得注意的是，反复发生胆管炎的患者组中C反应蛋白水平升高，而钠/氢交换体3水平降低。
本研究突出了KPE术后粪便蛋白质谱的明显差异，尤其是临床预后较差的患者。这表明粪便蛋白质组分析有可能深入了解KPE术后BA患者的肝脏原始状况，反映其临床状态。
