Hyaluronic acid: a specific prognostic indicator of hepatic damage in biliary atresia.
OBJECTIVE
Hepatic fibrosis can progress in biliary atresia (BA) and is associated with capillarization of hepatic sinusoids. The significance of serum hyaluronic acid (HA) as a noninvasive indicator of histological sinusoidal endothelial cell (SEC) damage and hepatic fibrosis in BA, is investigated.


METHODS
A total of 28 postoperative BA patients (mean age, 11.0+/-3.7 years) and 20 normal controls (mean age, 10.5+/-2.8 years) were studied. BA patients were divided into group I, good liver function (n = 8); group II, moderate liver dysfunction (n = 10); and group III, severe liver dysfunction (n = 10). Serum HA was determined using a one-step sandwich enzyme immunoassay, and liver histological damage was confirmed immunohistochemically using an antibody against factor VIII-related antigen (FVIIIRAg), which is specific for detecting damaged SEC.


RESULTS
Serum HA was significantly higher (P < .0001) in group III (84.6+/-36.5 ng/mL) than in group I (15.9+/-6.9 ng/mL) or group 11 (28.7+/-10.7 ng/mL). Although immunoreactive products of FVIIIRAg were abundant in group III, they were not detected in SEC from group II.


CONCLUSIONS
Serum HA may be of value for monitoring postoperative BA patients as a noninvasive indicator of SEC damage and progressive hepatic fibrosis.
Kobayashi
H
H
Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Horikoshi
K
K
Yamataka
A
A
Yamataka
T
T
Okazaki
T
T
Lane
G J
GJ
Miyano
T
T
D000293:Adolescent; D001656:Biliary Atresia / Q000473:pathology*; D015415:Biomarkers; D002648:Child; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D007150:Immunohistochemistry; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology*; D014841:von Willebrand Factor / Q000032:analysis
D015415:Biomarkers; D014841:von Willebrand Factor; D006820:Hyaluronic Acid