Clinical evaluation of serum levels of matrix metalloproteinases and tissue inhibitors of metalloproteinases as predictors of progressive fibrosis in postoperative biliary atresia patients.
OBJECTIVE
The authors analyzed serum Metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in postoperative biliary atresia (POBA) patients to evaluate their usefulness for assessing progressive fibrosis.


METHODS
The authors measured serum MMPs (-1,2) and TIMPs(-1,2) using respective one-step sandwich enzyme immunoassays in 36 POBA patients (mean age, 12.3 +/- 6.5 years) and 13 age-matched controls. POBA patients were classified into 3 groups; group I: n = 12; normal liver function test (LFT); group II: n = 15; elevated LFT, anicteric; and group III: n = 9; elevated LFT, icteric.


RESULTS
Serum MMP-2 levels were higher in all BA groups(especially in group II and III) compared with controls (P <.01). However, MMP-1 in all POBA patients groups (especially in group II and III) was significantly decreased compared with controls (P <.01). There was no statistical difference between mean values for serum TIMP-1 and TIMP-2 in all POBA patients compared with controls.


CONCLUSIONS
Serum MMPs levels might be useful for predicting the progress of fibrosis and the functional reserve in POBA patients with documented deterioration in liver function caused by fibrosis. Our finding that TIMPs do not rise as cirrhosis progresses and this imbalance may be a causal factor for the excessive accumulation of extracellular matrix, which, in turn, may contribute to the progression of fibrosis in BA.
Kobayashi
Hiroyuki
H
Department of Pediatric Surgery, Juntendo University School of Medicine Tokyo, Japan.
Li
Zhi-Xin
ZX
Yamataka
Atsuyuki
A
Lane
Geoffrey J
GJ
Miyano
Takeshi
T
D000293:Adolescent; D001656:Biliary Atresia / Q000150:complications*; D002648:Child; D018450:Disease Progression; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D020781:Matrix Metalloproteinase 1 / Q000097:blood*; D020778:Matrix Metalloproteinase 2 / Q000097:blood*; D019714:Tissue Inhibitor of Metalloproteinases / Q000097:blood*
D019714:Tissue Inhibitor of Metalloproteinases; D020778:Matrix Metalloproteinase 2; D020781:Matrix Metalloproteinase 1