Quantification of Serum Matrix Metallopeptide 7 Levels May Assist in the Diagnosis and Predict the Outcome for Patients with Biliary Atresia
Journal
Journal of Pediatrics
Journal Volume
208
Pages
30-37
Date Issued
2019
Abstract
Objective: To assess the diagnostic and prognostic usefulness of the serum matrix metallopeptidase-7 (MMP-7) level for biliary atresia in infants with cholestasis after hepatoportoenterostomy. Study design: We enrolled 100 infants with cholestasis (age, 43.56 ± 1.97 days; 62 males) with a direct bilirubin level of >1 mg/dL, of whom 36 (36%) were diagnosed with biliary atresisa. The MMP-7 levels in serum samples collected during the cholestasis workup and 6 months after hepatoportoenterostomy were assessed by enzyme-linked immunosorbent assay. We quantified liver fibrosis by Picro Sirius red staining of collagen in specimens from the 81 infants with cholestasis. Results: Infants with biliary atresisa had a significantly higher serum MMP-7 level than that of non–biliary atresisa infants with cholestasis of equivalent age (P <.0001). Receiver operating characteristic analysis showed that a serum MMP-7 level of >1.43 ng/mL was predictive of biliary atresisa in infants with cholestasis (diagnostic accuracy, 88%). There was a positive correlation between the serum MMP-7 level and the severity of liver fibrosis (P =.0002). Survival analysis showed that the frequency of liver transplantation was significantly higher in infants with biliary atresisa with a serum MMP-7 level of >10.30 ng/mL compared with a serum MMP-7 level of ?10.30 ng/mL after hepatoportoenterostomy (hazard ratio, 4.22; P =.02). Conclusions: The serum MMP-7 level, which reflects the severity of liver fibrosis and can be determined noninvasively, may facilitate the diagnosis of biliary atresisa among infants with cholestasis. Moreover, the serum MMP-7 level after hepatoportoenterostomy is associated with a need for liver transplantation in infants with biliary atresisa. ? 2019 Elsevier Inc.
SDGs
Other Subjects
alanine aminotransferase; aspartate aminotransferase; bilirubin; collagen; matrilysin; matrilysin; age; Article; aspartate aminotransferase blood level; bile duct atresia; bilirubin blood level; cholestasis; controlled study; diagnostic accuracy; diagnostic test accuracy study; disease severity; enzyme linked immunosorbent assay; esophagus varices; female; human; infant; jaundice; liver fibrosis; liver transplantation; major clinical study; male; portoenterostomy; priority journal; prognosis; protein blood level; splenomegaly; thrombocytopenia; adverse event; bile duct atresia; blood; cohort analysis; complication; enzymology; liver cirrhosis; predictive value; receiver operating characteristic; Biliary Atresia; Cholestasis; Cohort Studies; Female; Humans; Infant; Liver Cirrhosis; Liver Transplantation; Male; Matrix Metalloproteinase 7; Portoenterostomy, Hepatic; Predictive Value of Tests; ROC Curve
Publisher
Mosby Inc.
Type
journal article