Soluble ICAM-1 (sICAM-1) in biliary atresia and its relationship to disease activity.
BACKGROUND
Intercellular adhesion molecule-1 (ICAM-1) is strongly expressed on the bile ducts and hepatic parenchyma of livers with biliary atresia. A soluble, circulating form of this membrane protein has been found to be elevated in a number of inflammatory hepatic disorders. However, its expression in biliary atresia is unknown. The purpose of this study was to assess the presence of soluble ICAM-1 in infants with biliary atresia in relation to disease activity, degree of cholestasis, and standard liver function tests.


METHODS
A total of nine patients (n = 9) with biliary atresia (seven) and neonatal hyperbilirubinemia (two) were studied (age range 6 weeks-9 years). Control samples were obtained from three healthy infants (2-10 months). Serum was collected from each patient and stored at -80 degrees C until assayed. Levels of sICAM-1 were measured in duplicate utilizing an ELISA method (Bioscource International). Standard liver function tests (conjugated bilirubin, gamma-glutamyl transpeptidase, alkaline phosphatase, alanine aminotransferase) were determined at the same time. Results are expressed as the means +/- SEM with statistical analysis by Mann-Whitney test.


RESULTS
sICAM-1 levels were significantly elevated in all patients with biliary atresia (997 +/- 56 ng/ml) when compared to controls (P < 0.001). No correlation was found between sICAM-1 levels and conjugated bilirubin, gamma-glutamyl transpeptidase, alkaline phosphatase, and alanine aminotransferase levels or with clinical assessment of disease severity.


CONCLUSIONS
sICAM-1 is markedly elevated in biliary atresia reflecting the immunopathology of the disease process but does not appear to correlate with markers of liver function. sICAM-1 may be useful in assessing the effects of immunomodulatory therapy.
Department of Surgery, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey 17033, USA.
K E
KE
Minnick
R
R
Kreisberg
P W
PW
Dillon
D001656:Biliary Atresia / Q000097:blood* / Q000175:diagnosis; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood / Q000175:diagnosis; D007223:Infant; D007231:Infant, Newborn; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008111:Liver Function Tests; D008297:Male; D012995:Solubility
D015415:Biomarkers; D018799:Intercellular Adhesion Molecule-1