Biliary atresia and Cytokine

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ABSTRACTThis study was undertaken to investigate pathophysiology of long-term biliary atresia (BA) patients in terms of alterations in cytokine network control. In our study, serum IL-1 or related cytokines, and hematopoietic factors did not reveal any specific changes to define underlying hepatobilary and splenic pathologies. Among many cytokines, thrombopoietin (TPO), a newly reported one, was expected to be deeply involved in hypersplenism associated with liver cirrhosis as well as portal hypertension. However, the correlation between serum TPO levels and platelet counts proved to be insignificant possibly because the serum TPO levels are not dependent on platelet counts alone especially in patients with chronic liver disorders, but are determined promarily by an equilibrium state based on relevant factors which increase or decrease blood platelet counts. Accordingly, it seemed helpful in defining pathophysiological roles of TPO to determine serum TPO changes when these stable patients undergo substantial stresses like partial splenic embolization (PSE) for hypersplenism or living-related liver transplantation (LRLTx) for advanced liver cirrhosis. Serum TPO levels peaked 3 days after PSE whereas platelet count rose gradually with a peak at around 2 weeks. In patients who underwent LRTx, serum TPO showed a peak value at around 1 week with persistent low levels of platelet count irrespective of positive changes of TPO levels. These varying patterns of TPO and platelet count changes offered an important clue to identify the physiological role of TPO in pediatric chronic diseases of the liver including BA.