|Title:||A high serum interleukin-12p40 level prior to Kasai surgery predict a favourable outcome in children with biliary atresia||Authors:||HONG-YUAN HSU
|Issue Date:||2012||Journal Volume:||32||Journal Issue:||10||Start page/Pages:||1557-1563||Source:||Liver International||Abstract:||
Background: Biliary atresia (BA) is a paediatric cholestatic disease characterized by a progressive fibro-inflammation of the biliary tree. Current treatment of choice is to establish good bile flow via the Kasai operation. Aims: We aimed to identify outcome-predictive serum biomarkers in BA infant. Methods: Thirty-three BA children recruited from 1986 to 2007 served as the baseline-study group. An additional 11 children recruited from 2008 to 2011 served as the validation group. Serum samples were collected immediately before and 6?months after the Kasai operation for the assessment of serum cytokines, including tumour necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β), interferon-γ (IFN-γ), interleukin-2 (IL-2), IL-10, IL-12p40 and IL-12p70 as the candidate biomarkers. Results: Increased serum TGF-β levels indicated a lower Knodell hepatitis activity index at Kasai operation. The serum TGF-β levels declined after the operation. Serum IL-12p40 levels before the Kasai operation were higher in the subjects with a 3-month jaundice-free status than in others (P?=?0.001). A serum pre-operative IL-12p40 level of 33?pg/ml was predictive of a 3-month jaundice-free status after surgery (positive predictive value=81.0%; negative predictive value=83.3%). This biomarker was also predictive of a better outcome, in terms of 3-year survival with native liver (risk ratio [RR?=?4.00]; P?0.001), and 3-year jaundice-free survival with native liver (RR?=?12.00; P?0.001). We confirmed the predictive power of a high pre-operative IL-12p40 level on 3-month jaundice-free status in the validation group. Conclusions: The pre-operative IL-12p40 level was a good predictive biomarker of clinical outcome in children with BA undergoing the Kasai operation. ? 2012 John Wiley & Sons A/S.
|DOI:||10.1111/liv.12001||metadata.dc.subject.other:||biological marker; cytokine; gamma interferon; interleukin 10; interleukin 12p40; interleukin 12p70; interleukin 2; transforming growth factor beta; tumor necrosis factor alpha; article; bile duct atresia; bile flow; clinical article; female; human; infant; jaundice; male; portoenterostomy; preoperative evaluation; treatment outcome; Biliary Atresia; Biological Markers; Female; Humans; Infant; Interleukin-12 Subunit p40; Jaundice, Obstructive; Male; Odds Ratio; Portoenterostomy, Hepatic; Predictive Value of Tests; Prognosis; ROC Curve
|Appears in Collections:||醫學系|
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