Serum IFN-inducible protein-10: a new clinical prognostic predictor of hepatocyte death in biliary atresia.
OBJECTIVE
The aim of this study was to determine whether chemokines such as serum IP-10 levels in patients with biliary atresia (BA) correlate with liver function and histology and assess its value as a medium to long-term prediction of prognosis in postoperative BA patients.


METHODS
Thirty postoperative BA patients (mean age, 10.8+/-3.5 years) and eight normal controls (mean age, 10.3+/-3.3 years) were studied. The BA patients were divided into three groups according to liver function. Group I (n = 8) was jaundice free, had normal liver function and no evidence of severe cholangitis or portal hypertension. Group II (n = 12) had moderate liver dysfunction. Group III (n = 10), had severe liver dysfunction. Hepatic histology was assessed using conventional needle biopsy. Serum IP-10 levels were determined using a specific enzyme-linked immunosorbent assay (ELISA).


RESULTS
Serum levels of IP-10 in group III (458.0+/-240.0 pg/mL) were significantly higher than those in group II (233.6+/-126.9 pg/mL; P < .0001). Levels in group II were also significantly higher than those in group I (144.8+/-23.4 pg/mL; P < .05), but there was no significant difference between group I and controls (107.9+/-34.0 pg/mL). Liver biopsy findings showed a progression of fibrosis and mononuclear cell infiltration from group I to group III. There was intimal hyperplasia and swelling of endothelial cells of branches of the hepatic artery in the portal area in group III.


CONCLUSIONS
Because IP-10 levels correlate closely with histological findings in postoperative BA patients, it would appear to play a specific role in hepatocyte death and hepatic artery changes, thus providing important information about progressive fibrosis in BA patients that facilitates treatment decision making and prediction of prognosis.
Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan.
H
H
Kobayashi
S
S
Narumi
T
T
Tamatani
G J
GJ
Lane
T
T
Miyano
D001656:Biliary Atresia / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D019743:Chemokines, CXC / Q000097:blood*; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008099:Liver / Q000166:cytology*; D008111:Liver Function Tests; D008297:Male; D011237:Predictive Value of Tests
D019743:Chemokines, CXC