Published online Nov 28, 2016. doi: 10.4254/wjh.v8.i33.1471
Peer-review started: June 7, 2016
First decision: August 10, 2016
Revised: August 21, 2016
Accepted: October 22, 2016
Article in press: October 24, 2016
Published online: November 28, 2016
To investigate serum urokinase-type plasminogen activator receptor (uPAR) and liver stiffness in biliary atresia (BA) and examine the correlation of circulating uPAR, liver stiffness, and clinical outcomes in postoperative BA children.
Eighty-five postKasai BA children and 24 control subjects were registered. Circulating uPAR was measured using enzyme-linked immunosorbent essay. Liver stiffness was analyzed using transient elastography.
BA children had significantly greater circulating uPAR and liver stiffness scores than control subjects (P < 0.001). Circulating uPAR and liver stiffness were substantially higher in jaundiced BA children than non-jaundiced BA children (P < 0.001). In addition, circulating uPAR was positively associated with serum aspartate aminotransferase (r = 0.507, P < 0.001), alanine aminotransferase (r = 0.364, P < 0.001), total bilirubin (r = 0.559, P < 0.001), alkaline phosphatase (r = 0.325, P < 0.001), and liver stiffness scores (r = 0.508, P < 0.001).
Circulating uPAR and liver stiffness values were greater in BA children than healthy controls. The increased circulating uPAR was associated with liver dysfunction in BA. As a consequence, serum uPAR and liver stiffness may be used as noninvasive biomarkers indicating the progression of liver fibrosis in postKasai BA.
Core tip: Urokinase plasminogen activator receptor (uPAR) is known to be a substantial factor in the etiopathogenesis of hepatic inflammation and liver fibrogenesis. This study is the first to show that circulating uPAR is more elevated in biliary atresia (BA) children than in control subjects, and that circulating uPAR is correlated with the degree of jaundice and liver fibrosis in biliary atresia. Elevated serum uPAR is positively correlated with the severity of liver stiffness in postKasai BA children. Hence, serum uPAR could be used as a biological parameter indicating the progression and prognosis of liver fibrosis in BA children.