Soluble adhesion molecule profiling in preoperative infants with biliary atresia

Intercellular adhesion molecule (ICAM) expression in liver and bile duct remnant is a feature of the inflammatory component of biliary atresia (BA). Circulating levels of such soluble adhesion molecules (SAM) should reflect intrahepatic disease and would prove a useful adjunct in the evaluation of B...

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Veröffentlicht in:Journal of pediatric surgery 2005-09, Vol.40 (9), p.1464-1469
Hauptverfasser: Davenport, Mark, Gonde, Chris, Narayanaswamy, Bommayya, Mieli-Vergani, Giorgina, Tredger, J. Michael
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container_end_page 1469
container_issue 9
container_start_page 1464
container_title Journal of pediatric surgery
container_volume 40
creator Davenport, Mark
Gonde, Chris
Narayanaswamy, Bommayya
Mieli-Vergani, Giorgina
Tredger, J. Michael
description Intercellular adhesion molecule (ICAM) expression in liver and bile duct remnant is a feature of the inflammatory component of biliary atresia (BA). Circulating levels of such soluble adhesion molecules (SAM) should reflect intrahepatic disease and would prove a useful adjunct in the evaluation of BA. Serum ICAM-1 (sICAM-1), serum vascular cell adhesion molecule (sVCAM-1), and serum E selectin (sE-selectin) were measured by enzyme-linked immunosorbent assay in infants with BA at the time of portoenterostomy and stratified by outcome. Results are quoted as medians (range). Binary logistic regression analysis and actuarial survival curves were used to investigate the relationship of SAM profile to outcome. Significance was assumed at P values of ≤.05. Sixty-one infants with BA were treated between 1996 and 2002 and at follow-up; 39 of these were alive and jaundice-free (good outcome, n = 39); 21 had been transplanted, and 1 died (poor outcome, n = 22). Preoperative values for sICAM-1 were 1233 (400-2000) ng/mL; sVCAM-1, 1204 (517-1921) ng/mL; and sE-selectin, 71 (26-192) ng/mL. sVCAM-1 ( P < .0001) and sICAM-1 ( P < .0001) significantly increased compared with normal control infants, although sE-selectin did not ( P = .17). There was a significant correlation of age at surgery with sICAM-1 ( r = 0.33, P = .01) but not with sVCAM-1 ( r = 0.16, P = .23) or sE-selectin ( r = 0.05, P = .70). Binary logistic regression analysis showed that the variables, sICAM-1, sE-selectin, or age at surgery, were not significant predictors of outcome, although sVCAM-1 approached significance ( P = .069). A cutoff value for sVCAM-1 of 1380 ng/mL was defined by receiver operating characteristic curve analysis, and the cohort of patients with sVCAM-1 (>1380 ng/mL) showed a significantly worse actuarial survival ( P = .05). Levels of sICAM-1 and sVCAM-1 are grossly elevated in BA, whereas sE-selectin levels are normal. Only sVCAM-1 levels have prognostic significance. SAM profiling has the potential to monitor the inflammatory process of BA and may guide more novel forms of pharmacological intervention or immunomodulation.
doi_str_mv 10.1016/j.jpedsurg.2005.05.050
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Sixty-one infants with BA were treated between 1996 and 2002 and at follow-up; 39 of these were alive and jaundice-free (good outcome, n = 39); 21 had been transplanted, and 1 died (poor outcome, n = 22). Preoperative values for sICAM-1 were 1233 (400-2000) ng/mL; sVCAM-1, 1204 (517-1921) ng/mL; and sE-selectin, 71 (26-192) ng/mL. sVCAM-1 ( P &lt; .0001) and sICAM-1 ( P &lt; .0001) significantly increased compared with normal control infants, although sE-selectin did not ( P = .17). There was a significant correlation of age at surgery with sICAM-1 ( r = 0.33, P = .01) but not with sVCAM-1 ( r = 0.16, P = .23) or sE-selectin ( r = 0.05, P = .70). Binary logistic regression analysis showed that the variables, sICAM-1, sE-selectin, or age at surgery, were not significant predictors of outcome, although sVCAM-1 approached significance ( P = .069). A cutoff value for sVCAM-1 of 1380 ng/mL was defined by receiver operating characteristic curve analysis, and the cohort of patients with sVCAM-1 (&gt;1380 ng/mL) showed a significantly worse actuarial survival ( P = .05). Levels of sICAM-1 and sVCAM-1 are grossly elevated in BA, whereas sE-selectin levels are normal. Only sVCAM-1 levels have prognostic significance. 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Michael</creatorcontrib><title>Soluble adhesion molecule profiling in preoperative infants with biliary atresia</title><title>Journal of pediatric surgery</title><addtitle>J Pediatr Surg</addtitle><description>Intercellular adhesion molecule (ICAM) expression in liver and bile duct remnant is a feature of the inflammatory component of biliary atresia (BA). Circulating levels of such soluble adhesion molecules (SAM) should reflect intrahepatic disease and would prove a useful adjunct in the evaluation of BA. Serum ICAM-1 (sICAM-1), serum vascular cell adhesion molecule (sVCAM-1), and serum E selectin (sE-selectin) were measured by enzyme-linked immunosorbent assay in infants with BA at the time of portoenterostomy and stratified by outcome. Results are quoted as medians (range). Binary logistic regression analysis and actuarial survival curves were used to investigate the relationship of SAM profile to outcome. Significance was assumed at P values of ≤.05. Sixty-one infants with BA were treated between 1996 and 2002 and at follow-up; 39 of these were alive and jaundice-free (good outcome, n = 39); 21 had been transplanted, and 1 died (poor outcome, n = 22). Preoperative values for sICAM-1 were 1233 (400-2000) ng/mL; sVCAM-1, 1204 (517-1921) ng/mL; and sE-selectin, 71 (26-192) ng/mL. sVCAM-1 ( P &lt; .0001) and sICAM-1 ( P &lt; .0001) significantly increased compared with normal control infants, although sE-selectin did not ( P = .17). There was a significant correlation of age at surgery with sICAM-1 ( r = 0.33, P = .01) but not with sVCAM-1 ( r = 0.16, P = .23) or sE-selectin ( r = 0.05, P = .70). Binary logistic regression analysis showed that the variables, sICAM-1, sE-selectin, or age at surgery, were not significant predictors of outcome, although sVCAM-1 approached significance ( P = .069). A cutoff value for sVCAM-1 of 1380 ng/mL was defined by receiver operating characteristic curve analysis, and the cohort of patients with sVCAM-1 (&gt;1380 ng/mL) showed a significantly worse actuarial survival ( P = .05). Levels of sICAM-1 and sVCAM-1 are grossly elevated in BA, whereas sE-selectin levels are normal. Only sVCAM-1 levels have prognostic significance. 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Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c366t-8c926418db7f712542b5bdf6c4462e1de2284f09f43e9a549947b46810da02f73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Biliary Atresia - blood</topic><topic>Biliary Atresia - surgery</topic><topic>Biomarkers - blood</topic><topic>E-Selectin - blood</topic><topic>Enzyme-Linked Immunosorbent Assay</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intercellular Adhesion Molecule-1 - blood</topic><topic>Liver - physiology</topic><topic>Portoenterostomy, Hepatic</topic><topic>Predictive Value of Tests</topic><topic>Preoperative Care</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Reference Values</topic><topic>Regression Analysis</topic><topic>Survival Analysis</topic><topic>Vascular Cell Adhesion Molecule-1 - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Davenport, Mark</creatorcontrib><creatorcontrib>Gonde, Chris</creatorcontrib><creatorcontrib>Narayanaswamy, Bommayya</creatorcontrib><creatorcontrib>Mieli-Vergani, Giorgina</creatorcontrib><creatorcontrib>Tredger, J. 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Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Soluble adhesion molecule profiling in preoperative infants with biliary atresia</atitle><jtitle>Journal of pediatric surgery</jtitle><addtitle>J Pediatr Surg</addtitle><date>2005-09-01</date><risdate>2005</risdate><volume>40</volume><issue>9</issue><spage>1464</spage><epage>1469</epage><pages>1464-1469</pages><issn>0022-3468</issn><eissn>1531-5037</eissn><abstract>Intercellular adhesion molecule (ICAM) expression in liver and bile duct remnant is a feature of the inflammatory component of biliary atresia (BA). Circulating levels of such soluble adhesion molecules (SAM) should reflect intrahepatic disease and would prove a useful adjunct in the evaluation of BA. Serum ICAM-1 (sICAM-1), serum vascular cell adhesion molecule (sVCAM-1), and serum E selectin (sE-selectin) were measured by enzyme-linked immunosorbent assay in infants with BA at the time of portoenterostomy and stratified by outcome. Results are quoted as medians (range). Binary logistic regression analysis and actuarial survival curves were used to investigate the relationship of SAM profile to outcome. Significance was assumed at P values of ≤.05. Sixty-one infants with BA were treated between 1996 and 2002 and at follow-up; 39 of these were alive and jaundice-free (good outcome, n = 39); 21 had been transplanted, and 1 died (poor outcome, n = 22). Preoperative values for sICAM-1 were 1233 (400-2000) ng/mL; sVCAM-1, 1204 (517-1921) ng/mL; and sE-selectin, 71 (26-192) ng/mL. sVCAM-1 ( P &lt; .0001) and sICAM-1 ( P &lt; .0001) significantly increased compared with normal control infants, although sE-selectin did not ( P = .17). There was a significant correlation of age at surgery with sICAM-1 ( r = 0.33, P = .01) but not with sVCAM-1 ( r = 0.16, P = .23) or sE-selectin ( r = 0.05, P = .70). Binary logistic regression analysis showed that the variables, sICAM-1, sE-selectin, or age at surgery, were not significant predictors of outcome, although sVCAM-1 approached significance ( P = .069). A cutoff value for sVCAM-1 of 1380 ng/mL was defined by receiver operating characteristic curve analysis, and the cohort of patients with sVCAM-1 (&gt;1380 ng/mL) showed a significantly worse actuarial survival ( P = .05). Levels of sICAM-1 and sVCAM-1 are grossly elevated in BA, whereas sE-selectin levels are normal. Only sVCAM-1 levels have prognostic significance. SAM profiling has the potential to monitor the inflammatory process of BA and may guide more novel forms of pharmacological intervention or immunomodulation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>16150350</pmid><doi>10.1016/j.jpedsurg.2005.05.050</doi><tpages>6</tpages></addata></record>
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subjects Biliary Atresia - blood
Biliary Atresia - surgery
Biomarkers - blood
E-Selectin - blood
Enzyme-Linked Immunosorbent Assay
Humans
Infant
Infant, Newborn
Intercellular Adhesion Molecule-1 - blood
Liver - physiology
Portoenterostomy, Hepatic
Predictive Value of Tests
Preoperative Care
Prognosis
Prospective Studies
Reference Values
Regression Analysis
Survival Analysis
Vascular Cell Adhesion Molecule-1 - blood
title Soluble adhesion molecule profiling in preoperative infants with biliary atresia
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