High levels of serum basic fibroblast growth factor in children with biliary atresia

Area of Science:

• Pediatric Gastroenterology
• Hepatology
• Biochemistry

Background:

• Biliary atresia (BA) is a severe neonatal liver disease requiring surgical intervention.
• The Kasai operation is a common surgical procedure for BA.
• Understanding factors influencing clinical outcomes post-Kasai is crucial for patient management.

Purpose of the Study:

• To investigate the association between basic fibroblast growth factor (bFGF) levels and clinical outcomes in pediatric patients with biliary atresia (BA) after the Kasai operation.
• To determine if bFGF levels correlate with indicators of liver damage and disease severity.

Main Methods:

• Serum bFGF levels were measured using enzyme-linked immunosorbent assay (ELISA) in 65 pediatric BA patients post-Kasai operation and 12 healthy controls.
• Patients were stratified based on serum total bilirubin (TB) and alanine aminotransferase (ALT) levels.
• Correlation with portal hypertension (PH) was assessed in a subgroup.

Main Results:

• Mean serum bFGF levels were significantly higher in BA patients compared to healthy controls (14.2 vs. 9.0 pg/mL, p < 0.03).
• Elevated bFGF levels were observed in BA patients with persistent jaundice (TB ≥ 2 mg/dL), higher ALT levels (≥ 100 U/L), and presence of portal hypertension (p < 0.05 for all).
• Specifically, bFGF was significantly higher in patients with ALT ≥ 100 U/L (19.0 vs. 8.9 pg/mL, p < 0.0005).

Conclusions:

• Elevated serum bFGF levels in BA patients after the Kasai procedure are linked to indicators of severe liver damage and the presence of portal hypertension.
• bFGF may play a role in the ongoing inflammation and development of portal hypertension in BA.
• These findings highlight bFGF as a potential biomarker for disease severity and progression in biliary atresia.