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Elevated serum bone morphogenetic protein 7 levels and clinical outcome in children with biliary atresia
M Chayanupatkul1, S Honsawek, P Vejchapipat
1Faculty of Medicine, Department of Physiology, Chulalongkorn University, Bangkok, Thailand.
Insights
Serum bone morphogenetic protein 7 (BMP7) levels are elevated in children with biliary atresia (BA) and correlate with disease severity. Higher BMP7 indicates poorer liver function and progression, suggesting its use as a prognostic marker post-Kasai operation.
Area of Science:
- Pediatric Hepatology
- Biomarker Discovery
- Liver Disease Research
Background:
- Biliary atresia (BA) is a severe pediatric liver disorder.
- Understanding disease progression markers is crucial for patient outcomes.
Purpose of the Study:
- To investigate serum bone morphogenetic protein 7 (BMP7) levels in children with BA.
- To assess the association between serum BMP7 and clinical outcomes after the Kasai operation.
Main Methods:
- Serum BMP7 levels were measured using ELISA in 62 BA patients post-Kasai operation and 14 healthy controls.
- Patients were stratified by total bilirubin and alanine aminotransferase levels.
Main Results:
- Serum BMP7 was significantly higher in BA patients than in controls (p=0.002).
- Elevated BMP7 correlated with persistent jaundice (p=0.001), elevated ALT (p=0.003), and portal hypertension (p<0.001).
- A positive correlation was found between serum total bilirubin and serum BMP7 (r=0.57, p<0.001).
Conclusions:
- Increased serum BMP7 is linked to worsened liver function and advanced liver fibrosis in BA.
- Serum BMP7 shows potential as a prognostic biomarker for disease severity and monitoring progression in BA patients post-Kasai operation.
Background And Aim:
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).
Conclusion:
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.
