title: Urotensin II levels are an important marker for the severity of portal hypertension in children.
abstract: OBJECTIVE
  Urotensin II (U-II), a somatostatin-like cyclic peptide, was recently identified as the most potent human vasoconstrictor peptide; however, the contribution of U-II-mediated alterations in peripheral vascular tone in disease states such as chronic liver disease and portal hypertension is poorly characterised. There are no data examining U-II in chronic liver disease in children. In this study, we aimed to determine whether U-II levels in healthy children are ontogenically regulated and we explored the effect of chronic liver disease on peripheral circulating U-II levels.
  
  
  METHODS
  U-II levels from healthy controls (n = 129) were compared with a healthy adult population (n = 80) in addition to a well-characterised cohort of children with chronic liver disease (n = 20). U-II was measured by radioimmunoassay.
  
  
  RESULTS
  There was no correlation between U-II and age in healthy children (r2 = 0, P = 0.8). U-II levels were similar between the paediatric and the adult control populations (1.35 ± 0.96 vs 1.25 ± 0.78, P = 0.8). U-II was significantly elevated in children with liver disease compared with controls (1.35 ± 0.96 pmol/L vs 3.56 ± 2.21 pmol/L; P < 0.001). In addition, U-II levels positively correlated with severity of liver disease as determined by Child-Pugh score (P < 0.05) and paediatric end-stage liver disease score (P < 0.001). Levels of U-II also correlated with long-term clinical outcome.
  
  
  CONCLUSIONS
  These data suggest that U-II is an important marker of severity of portal hypertension in children. It is independent of age and may be a potential therapeutic target in the chronic liver disease population.
authors.affiliation: Department of Paediatrics, University of Melbourne, Melbourne, Australia.
authors.forename: Reshma
authors.initials: R
authors.lastname: Pawar
authors.forename: William
authors.initials: W
authors.lastname: Kemp
authors.forename: Stuart
authors.initials: S
authors.lastname: Roberts
authors.forename: Henry
authors.initials: H
authors.lastname: Krum
authors.forename: Tim
authors.initials: T
authors.lastname: Yandle
authors.forename: Winita
authors.initials: W
authors.lastname: Hardikar
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D058625:End Stage Liver Disease / Q000097:blood / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D007223:Infant; D008103:Liver Cirrhosis / Q000097:blood / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D008297:Male; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D014579:Urotensins / Q000097:blood*
chemical_list: D015415:Biomarkers; D014579:Urotensins; C029677:urotensin II