Clinical evaluation of serum levels of matrix metalloproteinases and tissue inhibitors of metalloproteinases as predictors of progressive fibrosis in postoperative biliary atresia patients

Abstract

Background/Purpose: The authors analyzed serum Metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in postoperative biliary atresia (POBA) patients to evaluate their usefulness for assessing progressive fibrosis. Methods: The authors measured serum MMPs (−1,2) and TIMPs(−1,2) using respective one-step sandwich enzyme immunoassays in 36 POBA patients (mean age, 12.3 ± 6.5 years) and 13 age-matched controls. POBA patients were classified into 3 groups; group I: n = 12; normal liver function test (LFT); group II: n = 15; elevated LFT, anicteric; and group III: n = 9; elevated LFT, icteric. Results: Serum MMP-2 levels were higher in all BA groups(especially in group II and III) compared with controls (P <.01). However, MMP-1 in all POBA patients groups (especially in group II and III) was significantly decreased compared with controls (P <.01). There was no statistical difference between mean values for serum TIMP-1 and TIMP-2 in all POBA patients compared with controls. Conclusions: Serum MMPs levels might be useful for predicting the progress of fibrosis and the functional reserve in POBA patients with documented deterioration in liver function caused by fibrosis. Our finding that TIMPs do not rise as cirrhosis progresses and this imbalance may be a causal factor for the excessive accumulation of extracellular matrix, which, in turn, may contribute to the progression of fibrosis in BA. J Pediatr Surg 37:1030-1033. Copyright 2002, Elsevier Science (USA). All rights reserved.