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-β1 (TGF-β1) and epidermal growth factor (EGF) are involved in the hepatic reparative process, our objective was to investigate whether serum TGF-β1 and serum EGF levels were associated with therapeutic outcomes in BA. Methods: Serum levels of TGF-β1 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-β1 and serum EGF levels were compared between the two groups of BA patients. Correlation analysis of serum TGF-β1 with serum EGF was carried out. Data are expressed as mean ±SD. Results: Serum TGF-β1 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-β1 and serum EGF levels than patients with poor outcomes (TGF-β1: 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-β1 was positively correlated with serum EGF (Pearson's r = 0.3418, p = 0.0046). Conclusion: Elevated serum TGF-β1 and serum EGF levels were associated with a good outcome in BA patients. There was a positive correlation between serum TGF-β1 and serum EGF. This suggests that the resultant TGF-β1 and EGF pathways may be involved in the pathophysiological process in postoperative BA.