Elevation of serum stem-cell factor in postoperative biliary atresia.
BACKGROUND
Biliary atresia (BA) is one of the most common causes of neonatal cholestasis. Stem-cell factor (SCF) has been implicated in the development of fibrosis in various diseases. The objective of the present study was to examine the significant role of SCF in BA.


METHODS
Fifty-seven pediatric patients with BA after Kasai operation and 30 healthy children were recruited. The mean ages of BA patients and controls were 6.1 +/- 0.6 years and 6.1 +/- 0.7 years, respectively. The patients were categorized into two groups according to their serum levels of total bilirubin (TBil < 2 mg/dL, no jaundice vs TBil > or = 2 mg/dL, persistent jaundice) and alanine aminotransferase (ALT < 100 vs ALT > or = 100 U/L). The serum SCF levels were determined on commercially available enzyme-linked immunosorbent assay.


RESULTS
The mean serum SCF level of the BA children was higher than that of normal controls (748.3 +/- 17.9 pg/mL vs 582.2 +/- 17.3 pg/mL; P < 0.001). Subsequent analysis demonstrated that the BA patients with serum ALT > or = 100 U/L had significantly greater levels of serum SCF compared to those with serum ALT < 100 U/L (796.5 +/- 22.6 pg/mL vs 694.7 +/- 25.0 pg/mL, respectively; P = 0.002). In addition, serum SCF levels were significantly elevated in the patients with portal hypertension (PH) compared with those without PH (810.0 +/- 18.8 pg/mL vs 634.1 +/- 20.1 pg/mL, P < 0.001).


CONCLUSIONS
The current study showed that BA patients had higher serum SCF levels compared with controls. The significant elevation in SCF levels is associated with the presence of PH and the degree of hepatic injury. These findings suggest that SCF may play a part in the pathogenesis of hepatic fibrosis in BA patients after Kasai procedure.
Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Sittisak
S
Honsawek
Voranush
V
Chongsrisawat
Paisarn
P
Vejchapipat
Nutchanart
N
Thawornsuk
Pisit
P
Tangkijvanich
Yong
Y
Poovorawan
D001656:Biliary Atresia / Q000097:blood* / Q000601:surgery; D001663:Bilirubin / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011171:Portoenterostomy, Hepatic; D011183:Postoperative Complications / Q000097:blood*; D012016:Reference Values; D019089:Stem Cell Factor / Q000097:blood*; D014166:Transferases / Q000097:blood; D016896:Treatment Outcome
D019089:Stem Cell Factor; D014166:Transferases; D001663:Bilirubin