Serum IFN-Inducible protein-10: A new clinical prognostic predictor of hepatocyte death in biliary atresia

Purpose: The aim of this study was to determine whether chemokines such as serum IP-10 levels in patients with biliary atresia (BA) correlate with liv er function and histology and assess its value as a medium to long-term pre diction of prognosis in postoperative BA patients. Methods: Thirty postoperative BA patients (mean age, 10.8 +/- 3.5 years) an d eight normal controls (mean age, 10.3 +/- 3.3 years) were studied. The BA patients were divided into three groups according to liver function. Group I (n = 8) was jaundice free, had normal liver function and no evidence of severe cholangitis or portal hypertension. Group II (n = 12) had moderate l iver dysfunction. Group Ill (n = 10), had severe liver dysfunction. Hepatic histology was assessed using conventional needle biopsy. Serum IP-10 level s were determined using a specific enzyme-linked immunosorbent assay (ELISA ). Results: Serum levels of IP-10 in group ill (458.0 +/- 240.0 pg/mL) were si gnificantly higher than those in group Il (233.6 +/- 126.9 pg/mL; P <.0001) . Levels in group fl were also significantly higher than those in group 1 ( 144.8 +/- 23.4 pg/ mL; P <.05), but there was no significant difference bet ween group I and controls (107.9 +/- 34.0 pg/mL). Liver biopsy findings sho wed a progression of fibrosis and mononuclear cell infiltration from group I to group Ill. There was intimal hyperplasia and swelling of endothelial c ells of branches of the hepatic artery in the portal area in group III. Conclusion: Because IP-10 levels correlate closely with histological findin gs in postoperative BA patients, it would appear to play a specific role in hepatocyte death and hepatic artery changes, thus providing important info rmation about progressive fibrosis in BA patients that facilitates treatmen t decision making and prediction of prognosis.