DEVELOPMENT OF MASS SCREENING METHOD FOR CONGENITAL BILIARY ATRESIA.

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The estsablishment of the diagnosis of congenital liver disorder is urgently required for the remedy of liver disorder in early life. The metabolism of bile acids in fetus and neonate is thought to be different from that in adults. The aim of this reaserch is the developement of quantitative analysis of fetal bile acids by GC-MS and immunological assay, elucidation of the profiles of bile acids with hepatobiliary diseases, and establishment of the precise diagnosis and mass screening of congenital biliary atresia.1. A highly sensitive GC-MS determination of the fetal bile acids in neonatal serum and dried blood spot disc has been developed by capillary GC-MS using selected ion monitoring with negative ion chemical ionization. Diagnostic bile acid analysis of neonatal liver diseases was accomplished by GC-MS.2. An improved quantitative analysis of the conjugated fetal bile acids in urine of newborns has been developed by HPLC employing labeling with 1-anthroyl cyanide and fluorescence detection.3. A highly sensitive enzyme immunoassay of conjugated 1beta-hydroxycholic acid in heterologous combination has been developed using horse radish peroxidase labeled antigen. Concentrations of the conjugated bile acid in dried blood spotted onto filter paper in newborns with congenital biliary atresia were significantly higher than those of normal newborns, showing the possibility of mass screening for the disorder.