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

Background and Aim: Biliary atresia (BA) is a serious liver disease in children. Since transforming growth factor-beta 1 (TGF-beta 1) and epidermal growth factor (EGF) are involved in the hepatic reparative process, our objective was to investigate whether serum TGF-beta 1 and serum EGF levels were associated with therapeutic outcomes in BA. Methods: Serum levels of TGF-beta 1 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-beta 1 and serum EGF levels were compared between the two groups of BA patients. Correlation analysis of serum TGF-beta 1 with serum EGF was carried out. Data are expressed as mean +/- SD. Results: Serum TGF-beta 1 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 +/- 88.9pg/ml, p=0.744). Further subgroup analysis showed that patients with good outcomes (n=40) had higher serum TGF-pl and serum EGF levels than patients with poor outcomes (TGF-beta 1: 91.2 +/- 16.5 vs. 79.6 +/- 11.7 ng/ml, p = 0.002; EGF: 148.5 +/- 65.0 vs. 110.3 +/- 63.4pg/ml, p=0.02). In addition, serum TGF-pl was positively correlated with serum EGF(Pearson's r=0.3418, p=0.0046). Conclusion: Elevated serum TGF-beta 1 and serum EGF levels were associated with a good outcome in BA patients. There was a positive correlation between serum TGF-beta 1 and serum EGF. This suggests that the resultant TGF-beta 1 and EGF pathways may be involved in the pathophysiological process in postoperative BA.