title: Correlation of circulating endoglin with clinical outcome in biliary atresia.
abstract: OBJECTIVE
  Biliary atresia (BA) is a chronic progressive inflammatory disorder of the extrahepatic and intrahepatic biliary system in children. The aim of the present study was to investigate circulating endoglin levels in BA patients compared with healthy controls and to determine the relationship between plasma endoglin levels and outcome parameters of BA patients after Kasai operation.
  
  
  METHODS
  Fifty-five postoperative BA patients and 14 healthy controls were recruited. The patients were divided into two groups based on their serum total bilirubin levels (TB<34.2, no jaundice vs. TB>or=34.2 micromol/L, persistent jaundice) and serum alanine aminotransferase (ALT<45, normal ALT vs. ALT>or=45 IU/L, high ALT). Circulating endoglin levels were analyzed by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Average levels of plasma endoglin were significantly higher in BA patients compared to healthy controls (7.8+/-0.4 vs. 6.5+/-0.4 ng/mL; P=0.02). BA patients with persistent jaundice had higher plasma endoglin levels than those without jaundice (9.2+/-0.8 vs. 6.9+/-0.3 ng/mL; P=0.006). Furthermore, the concentrations of plasma endoglin in BA patients with high ALT were significantly higher compared to those with normal ALT (8.5+/-0.5 vs. 6.3+/-0.5 ng/mL, P=0.003). In addition, BA patients with portal hypertension had more elevated plasma endoglin levels than those without portal hypertension (8.8+/-0.6 vs. 6.1+/-0.3 ng/mL, P=0.001). Plasma endoglin was positively correlated with serum ALT (r=0.36, P=0.007) and serum GGT (r=0.44, P=0.001).
  
  
  CONCLUSIONS
  High circulating endoglin correlated with a poor outcome for BA. Plasma endoglin can be utilized as a potential biomarker reflecting the severity of ongoing liver injury and biliary obstruction in BA patients after Kasai procedure.
authors.affiliation: Faculty of Medicine Chulalongkorn University, Parasitology, Bangkok, Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Preativatanyou
authors.forename: S
authors.initials: S
authors.lastname: Honsawek
authors.forename: V
authors.initials: V
authors.lastname: Chongsrisawat
authors.forename: P
authors.initials: P
authors.lastname: Vejchapipat
authors.forename: A
authors.initials: A
authors.lastname: Theamboonlers
authors.forename: Y
authors.initials: Y
authors.lastname: Poovorawan
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000713:Anastomosis, Roux-en-Y / Q000379:methods; D015703:Antigens, CD / Q000097:blood*; D001656:Biliary Atresia / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002648:Child; D000071063:Endoglin; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011171:Portoenterostomy, Hepatic / Q000379:methods; D011184:Postoperative Period; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000097:blood*; D012720:Severity of Illness Index
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; C064206:ENG protein, human; D000071063:Endoglin; D011956:Receptors, Cell Surface; D000410:Alanine Transaminase; D001663:Bilirubin