Childhood Liver Disease Research and Education Network Clinical Center in Seattle

描述（由申请人提供）： 胆道闭锁和其他儿童期胆汁淤积性肝病是小儿肝病的重要病因。受到当前BARC和CLiC联盟研究重要性的鼓舞，NIDDK正在创建ChiLDREN，这是一个新的联盟，将取代BARC和CLiC，并扩大研究站点的数量。默里博士和她的研究小组建议在西雅图建立一个临床中心，作为儿童健康研究的一部分。该临床中心汇集了西北和阿拉斯加的患者，在儿科肝病研究和BARC试验，儿童胆汁淤积性疾病的诊断和管理方面经验丰富的研究人员，西北地区唯一的儿科肝移植中心，以及西雅图儿童和华盛顿大学的资源。患者人群的范围，再加上该西雅图临床中心研究者丰富的临床项目和经验，确保该研究团队将成功招募大量患有胆道闭锁和其他胆汁淤积性肝病的儿童进入该网络的纵向自然史和数据库研究、胆道闭锁皮质类固醇治疗试验以及未来的辅助和初步研究。培养下一代儿科肝病研究人员的能力，并通过西雅图儿童医院与胆道闭锁相关的临床和实验室研究专业知识，为疾病的科学理解做出贡献，确保临床中心对这些疾病的理解做出贡献。Murray博士计划在西雅图建立ChiLDREN临床中心，并继续目前批准的BARC和CLiC网络的纵向和治疗研究（具体目标1）。她提出了一项初步/可行性研究（具体目标2）的建议，评价胆道闭锁中的母体微嵌合体和由此产生的同种异体外周免疫反应作为该疾病的潜在致病病因。Murray博士还提出了西雅图临床中心独有的培训机会，以帮助教育和培训未来的儿科肝病研究人员（具体目标3）。 相关性：胆道闭锁等儿童胆汁淤积性肝病是儿童慢性肝病的重要原因，也是肝移植的首要原因。两个相关临床研究网络的初步供资期是成功的，但需要扩大工作。下一个资助期将扩大目前正在进行的自然史，遗传学和治疗研究，并探索与这些条件相关的新问题的答案。

DESCRIPTION (provided by applicant): Biliary atresia and the other cholestatic liver diseases of childhood are important causes of pediatric liver disease. Encouraged by the significance of the research of the current BARC and CLiC consortia, the NIDDK is creating ChiLDREN, a new consortium that will replace BARC and CLiC and expand the number of research sites. Dr. Murray and her research team propose to establish a Clinical Center in Seattle as part of ChiLDREN. This Clinical Center brings together the patients of the Northwest and Alaska, investigators experienced in pediatric liver disease research and the BARC trials, the diagnosis and management of childhood cholestatic diseases, the only pediatric liver transplant center in the Northwest, and the resources of Seattle Children's and the University of Washington. The scope of the patient population, coupled with the richness of the clinical programs and experience of the investigators of this Seattle Clinical Center; assure that this research team will successfully enroll a large number of children with biliary atresia and other cholestatic liver diseases into the network's longitudinal natural history and database studies, the biliary atresia corticosteroid treatment trial, and future ancillary and pilot studies. The ability to train the next generation of pediatric liver disease researchers and contribute to the scientific understanding of the diseases via the clinical and laboratory research expertise relevant to biliary atresia at Seattle Children's, assure the contributions by the Clinical Center to forwarding the understanding of these conditions. Dr. Murray plans to establish the ChiLDREN Clinical Center in Seattle, and continue the currently approved longitudinal and treatment studies of the current BARC and CLiC Networks (Specific Aim 1). She has included a proposal for a pilot/feasibility study (Specific Aim 2) evaluating maternal microchimerism in biliary atresia and the resultant allogeneic peripheral immune response as a possible pathogenic etiology underlying this condition. Dr. Murray has also proposed training opportunities unique to the Seattle Clinical Center to help educate and train the pediatric liver disease researchers of the future (Specific Aim 3). Relevance: Biliary atresia and the other childhood cholestatic liver diseases are important causes of chronic liver disease in children, and the leading cause for liver transplantation. The initial funding period for the two relevant clinical research networks has been successful, however, expansion of the work is necessary. This next funding period will expand the currently ongoing research of natural history, genetics, and treatment, and explore answers to new questions relevant to these conditions.