title: Elevated serum bone morphogenetic protein 7 levels and clinical outcome in children with biliary atresia.
abstract: OBJECTIVE
  Biliary atresia (BA) is one of the most serious liver disorders in children. The purposes of the present study were to investigate serum levels of bone morphogenetic protein 7 (BMP7) in BA children compared with healthy controls and to evaluate the association between serum BMP7 and the clinical outcome of BA patients post Kasai operation.
  
  
  METHODS
  Sixty-two BA patients post Kasai operation and 14 healthy controls were enrolled. The patients were divided into two groups according to their serum total bilirubin levels (TB<2, no jaundice vs. TB> or =2 mg/dL, persistent jaundice) and alanine aminotransferase levels (ALT<45, normal ALT vs. ALT> or =45 IU/L, elevated ALT). Serum BMP7 levels were determined by commercial enzyme-linked immunoabsorbent assay.
  
  
  RESULTS
  The mean serum BMP7 was higher in BA patients compared with that of healthy controls (35.4+/-3.6 vs. 20.6+/-2.7 pg/mL, p=0.002). The BA patients with persistent jaundice had more elevated serum BMP7 levels than those without jaundice (59.5+/-6.5 vs. 20.3+/-1.6 pg/mL, p=0.001). There was also a correlation between serum total bilirubin and serum BMP7 levels (r=0.57, p<0.001). Moreover, the levels of serum BMP7 in BA patients with elevated ALT were significantly higher than those with normal ALT (41.6+/-4.7 vs. 22.4+/-4.2 pg/mL, p=0.003). Additionally, BA patients with portal hypertension had higher increased serum BMP7 levels compared to those without portal hypertension (45.3+/-4.9 vs. 18.7+/-2.8 pg/mL, p<0.001).
  
  
  CONCLUSIONS
  The significant increment of serum BMP7 was associated with a deterioration of hepatic function and the progression of liver fibrosis. Serum BMP7 could be used as a prognostic marker to reflect disease severity and monitor disease progression in BA patients post Kasai operation.
authors.affiliation: Faculty of Medicine, Department of Physiology, Chulalongkorn University, Bangkok, Thailand.
authors.forename: M
authors.initials: M
authors.lastname: Chayanupatkul
authors.forename: S
authors.initials: S
authors.lastname: Honsawek
authors.forename: P
authors.initials: P
authors.lastname: Vejchapipat
authors.forename: V
authors.initials: V
authors.lastname: Chongsrisawat
authors.forename: Y
authors.initials: Y
authors.lastname: Poovorawan
mesh_terms: D001656:Biliary Atresia / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D055419:Bone Morphogenetic Protein 7 / Q000097:blood*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D055419:Bone Morphogenetic Protein 7