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Serum matrix metalloproteinase-7 levels in infants with cholestasis and biliary atresia
Pejman Rohani1, Seyyed Bahador Mirrahimi1, Haleh Bashirirad1
1Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Matrix metalloproteinase 7 (MMP7) shows high accuracy in diagnosing biliary atresia (BA) in infants. This biomarker effectively differentiates BA from other cholestasis causes, offering improved diagnostic capabilities.
Area of Science:
- Pediatric Gastroenterology
- Biomarker Discovery
- Neonatal cholestasis
Background:
- Cholestasis in infants requires accurate diagnosis to differentiate serious conditions like biliary atresia (BA).
- Current diagnostic methods can be invasive or lack specificity.
- Identifying reliable non-invasive biomarkers is crucial for early detection and treatment.
Purpose of the Study:
- To evaluate serum matrix metalloproteinase 7 (MMP7) levels in infants with cholestasis.
- To assess the diagnostic performance of MMP7 in distinguishing biliary atresia (BA) from other causes of infantile cholestasis.
- To compare MMP7 with Gamma-glutamyl Transferase (GGT) as a diagnostic marker.
Main Methods:
- A multi-center study involving 54 infants with cholestasis and 41 healthy controls.
- Serum MMP7 and Gamma-glutamyl Transferase (GGT) levels were measured.
- Sensitivity, specificity, and Area Under the Curve (AUC) were calculated for diagnostic accuracy.
Main Results:
- Mean serum MMP7 levels were significantly higher in infants with BA (15.91 ng/ml) compared to non-BA cholestasis (4.73 ng/ml) and controls (0.49 ng/ml).
- MMP7 achieved 95.5% sensitivity and 94.5% specificity for differentiating BA, with an AUC of 0.988.
- GGT showed lower diagnostic performance (77.3% sensitivity, 77.8% specificity, AUC 0.854).
Conclusions:
- Serum MMP7 is a highly accurate biomarker for differentiating biliary atresia in infants.
- MMP7 offers superior diagnostic performance compared to GGT for infantile cholestasis.
- This finding supports MMP7 as a valuable non-invasive tool for early BA diagnosis.
Background:
The aim of this study was to evaluate the serum level of matrix metalloproteinase 7 (MMP7) in infants with cholestasis and the diagnostic values of this biomarker to differentiate biliary atresia (BA) from other causes of cholestasis.
Methods:
This multi-center study is conducted during 2 years in Mofid children's hospital and Children's Medical Center, Pediatrics Center of Excellence Tehran, Iran. 54 infants with cholestasis were enrolled in this study with a control group consists of 41 healthy infants with the same age. Serum samples were taken from all these patients to assess serum levels of MMP7, Gamma-glutamyl Transferase (GGT). For each biomarker, we calculated the sensitivity and specificity and other statistical characteristics.
Results:
There were 89 subjects, 22 patients with BA, 32 patients with non-BA cholestasis and 41 subjects as control group. The mean serum MMP7 levels in BA, non-BA cholestasis and control group was 15.91 ng/ml ± 6.64, 4.73 ng/ml ± 2.59 and 0.49 ng/ml ± 0.33, respectively. The best cut-off point is calculated 7.8 ng/ml for MMP7 and 434.5 U/L for GGT. The area under curve (AUC) for these two markers are 0.988 ± 0.008 and 0.854 ± 0.052, respectively. The sensitivity and specificity of MMP7 to differentiate biliary atresia from nonbiliary atresia cholestasis in our study was 95.5% and 94.5%, respectively. The sensitivity and specificity of GGT was 77.3% and 77.8%, respectively. These results show that the MMP7 has more sensitivity and specificity in differentiation.
Conclusion:
MMP7 demonstrated good accuracy to differentiate biliary atresia from other causes of cholestasis.
