Serum Transforming Growth Factor-β1 and Epidermal Growth Factor in Biliary Atresia

Abstract

Biliary atresia (BA) is a serious liver disease in children. Since transforming growth factor-beta1 (TGF-beta1) and epidermal growth factor (EGF) are involved in the hepatic reparative process, our objective was to investigate whether serum TGF-beta1 and serum EGF levels were associated with therapeutic outcomes in BA. Serum levels of TGF-beta1 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-beta1 and serum EGF levels were compared between the two groups of BA patients. Correlation analysis of serum TGF-beta1 with serum EGF was carried out. Data are expressed as mean +/- SD. Serum TGF-beta1 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-beta1 and serum EGF levels than patients with poor outcomes (TGF-beta1: 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-beta1 was positively correlated with serum EGF (Pearson's r = 0.3418, p = 0.0046). Elevated serum TGF-beta1 and serum EGF levels were associated with a good outcome in BA patients. There was a positive correlation between serum TGF-beta1 and serum EGF. This suggests that the resultant TGF-beta1 and EGF pathways may be involved in the pathophysiological process in postoperative BA.