title: Apelin is a marker of the progression of liver fibrosis and portal hypertension in patients with biliary atresia.
abstract: OBJECTIVE
  Apelin, the endogenous ligand of the angiotensin-like-receptor 1 (APJ), is thought to play an important role in liver disease. This study investigated the apelin expression in different stages of biliary atresia (BA) and investigated whether it is associated with the progression of disease.
  
  
  METHODS
  Liver tissues were obtained from patients at Kasai's procedure (KP), the follow-up stage after KP (Post-KP) and at liver transplantation (LT). Immunohistochemistry for apelin and its receptor APJ and real-time quantitative reverse transcriptase polymerase chain reaction for apelin mRNA expression were conducted.
  
  
  RESULTS
  The immunohistochemical study revealed that apelin was mainly localized in the perivenular areas of control liver tissue, and slightly detected in the hepatic stellate cells (HSC) and hepatocytes, whereas intense apelin immunoreactivity was detected in perivenular areas, HSC and hepatocytes of LT liver tissue. The apelin mRNA expression level was significantly higher in the LT group than in the KP and Post-KP group. Significant linear correlations were observed between the apelin mRNA level and liver fibrosis, serum total bilirubin and the grade of esophageal varices.
  
  
  CONCLUSIONS
  The hepatic apelin-APJ system is markedly activated in the progression of BA, especially in end-stage cirrhosis. The apelin expression level accurately reflects the severity of hepatic fibrosis and esophageal varices and therefore could be used as a prognostic factor in BA patients.
authors.affiliation: Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Takaharu
authors.initials: T
authors.lastname: Oue
authors.forename: Takehisa
authors.initials: T
authors.lastname: Ueno
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Uehara
authors.forename: Noriaki
authors.initials: N
authors.lastname: Usui
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fukuzawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000073861:Apelin; D001656:Biliary Atresia / Q000150:complications* / Q000378:metabolism*; D015415:Biomarkers / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D007223:Infant; D036341:Intercellular Signaling Peptides and Proteins / Q000032:analysis / Q000096:biosynthesis*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D055815:Young Adult
chemical_list: C115436:APLN protein, human; D000073861:Apelin; D015415:Biomarkers; D036341:Intercellular Signaling Peptides and Proteins