Abstract
Background and Aim: Biliary atresia (BA) is a serious liver disease in children. Since transforming growth
factor-β1 (TGF-β1) and epidermal growth factor (EGF) are involved in the hepatic reparative
process, our objective was to investigate whether serum TGF-β1 and serum EGF levels
were associated with therapeutic outcomes in BA. Methods: Serum levels of TGF-β1 and EGF were determined with the ELISA method in 67 postoperative
BA patients with a median age of 7 years and in 10 age-comparable healthy children.
The BA patients were then divided into two groups depending on their therapeutic outcome:
good outcome (jaundice-free) and poor outcome (persistent jaundice). Clinical data,
serum TGF-β1 and serum EGF levels were compared between the two groups of BA patients.
Correlation analysis of serum TGF-β1 with serum EGF was carried out. Data are expressed
as mean ± SD. Results: Serum TGF-β1 levels of BA patients were higher than those of controls (86.6 ± 15.7
vs. 75.7 ± 8.8 ng/ml, p = 0.0362). However, there was no difference in serum EGF between
BA patients and controls (133.1 ± 66.6 vs. 125.4 ± 88.9 pg/ml, p = 0.744). Further
subgroup analysis showed that patients with good outcomes (n = 40) had higher serum
TGF-β1 and serum EGF levels than patients with poor outcomes (TGF-β1: 91.2 ± 16.5
vs. 79.6 ± 11.7 ng/ml, p = 0.002; EGF: 148.5 ± 65.0 vs. 110.3 ± 63.4 pg/ml, p = 0.02).
In addition, serum TGF-β1 was positively correlated with serum EGF (Pearson's r = 0.3418,
p = 0.0046). Conclusion: Elevated serum TGF-β1 and serum EGF levels were associated with a good outcome in
BA patients. There was a positive correlation between serum TGF-β1 and serum EGF.
This suggests that the resultant TGF-β1 and EGF pathways may be involved in the pathophysiological
process in postoperative BA.
Key words
biliary atresia - TGF - EGF
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Dr. M.D., Ph.D. Paisarn Vejchapipat
Department of Surgery
Chulalongkorn Hospital
Rama IV road, Patumwan
10330 Bangkok
Thailand
Email: pvejchap@yahoo.co.uk