Elevated Serum Macrophage Migration Inhibitory Factor Levels in Post-operative Biliary Atresia

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Biliary atresia (BA) is one of the most common causes of neonatal cholestasis. Macrophage migration inhibitory factor (MIF) is an important mediator of inflammation and immune response in various diseases. The objective of this study was to examine the possible roles of MIF in BA. Forty-eight BA paediatric patients who had undergone a Kasai operation and 22 healthy children were recruited. The mean ages of the patients and controls were 8.47 +/- 0.74 and 7.64 +/- 0.41 years, respectively. The patients were categorised into two groups according to their serum levels of total bilirubin (TB) (TB < 2 mg/dL; no jaundice, and TB >/= 2 mg/dL; persistent jaundice). The serum MIF levels were determined using commercially available enzyme-linked immunosorbent assay. The mean serum MIF level of the BA children was higher than that of healthy controls (0.43 +/- 0.04 ng/mL [corrected] vs. 0.27 +/- 0.02 ng/mL; [corrected] p < 0.001). However, there was no difference in serum MIF levels between BA patients with jaundice and those without jaundice. Further analysis revealed that there was no difference in serum MIF levels of BA patients without portal hypertension compared to that of BA patients with portal hypertension. MIF production was elevated in BA patients compared to normal controls. It is likely that MIF plays a role in the pathophysiology of post-operative BA patients. However, the elevated MIF levels are not associated with either jaundice status or portal hypertension.