Questioning Diagnostic Value of Serum Matrix Metalloproteinase 7 for Biliary Atresia

Karbasian, Fereshteh; Mashhadiagha, Amirali; Anbardar, Mohammad Hossein; Ataollahi, Maryam; Dehghani, Seyed Mohsen; Honar, Naser; Haghighat, Mahmood; Imanieh, Mohammad Hadi; Sayadi, Mehrab; Shahramian, Iraj; Aghsam, Ali; Hosseini, Amirhossein; Mortazavi, Seyedeh Maryam Mahadavi; Darban, Behnaz; Avazpour, Abbas; Mirrahimi, Bahador; Ruzbahani, Arian Karimi; Tadayon, Ali

doi:10.1016/j.jceh.2022.10.001

Cited by 8 publications

(6 citation statements)

References 21 publications

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“…There are currently 9 published Asian series supporting the use of serum MMP-7 level as the new gold standard diagnostic test in BA (5–13) (Table 1). The first striking feature is that published MMP-7 cut-off values vary hugely between the published studies with more than a 40-fold difference.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, serum level of matrix metalloproteinase-7 (MMP-7) has been studied as promising biomarker to accurately distinguish BA from other causes of neonatal cholestasis (4)(5)(6)(7)(8)(9)(10)(11)(12)(13). A recent systematic review of the value of pre-Kasai MMP-7 serum levels in detecting BA reported a collective sensitivity and speciicity of 96% and 91%, respectively (14).…”

mentioning

confidence: 99%

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Matrix Metalloproteinase-7 and Osteopontin Serum Levels as Biomarkers for Biliary Atresia

Aldeiri¹,

Si²,

Huang³

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: Matrix metallopeptidase-7 (MMP-7) and osteopontin (OPN) are important components in the pathophysiology of fibrosis in biliary atresia (BA). There has been much recent interest in MMP-7 serum level in the diagnosis of BA. We aimed to assess the diagnostic accuracy and prognostic value of both MMP-7 and OPN in a Western BA study. Methods: Diagnostic value was assessed by comparison of serum MMP-7 and OPN levels in infants with BA and age-matched cholestatic controls. Prognostic value was assessed through subsequent clearance of jaundice (COJ) and need for liver transplantation (LT). Results: Serum was assessed from 32 BA and 27 controls. Median MMP-7 was higher in BA (96.4 vs 35 ng/mL; P < 0.0001) with an optimal cut-off value of 69 ng/mL. Sensitivity and specificity was 68% and 93%, respectively [negative predictive value (NPV) = 71%]. Similarly, median OPN was higher in BA (1952 vs 1457 ng/mL; P = 0.0001) and an optimal cut-off of 1611 ng/mL. Sensitivity and specificity was 84% and 78%, respectively (NPV = 81%). MMP-7 level correlated positively with Ishak liver fibrosis score (r = 0.27, P = 0.04). Neither MMP-7 (70 vs 100 ng/mL; P = 0.2) nor OPN (1969 vs 1939 ng/mL; P = 0.3) were predictive of COJ, or need for LT (99 vs 79 ng/mL; P = 0.7, and 1981 vs 1899 ng/mL; P = 0.2), respectively. Conclusions: MMP-7 and OPN may have contributory value in the diagnosis of BA, but remain far of the "gold standard" role. Much more prospective data are required and collaborative multi-center initiatives should be the next logical steps.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Matrix Metalloproteinase-7 and Osteopontin Serum Levels as Biomarkers for Biliary Atresia

Aldeiri¹,

Si²,

Huang³

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…Sakaguchi et al [ 22 ] and the review by Tang et al [ 24 ] found that serum MMP-7 is a useful marker for the diagnosis of BA. However, Karbasian et al [ 14 ] questioned the diagnostic value of MMP7 in differentiating BA from non-BA cases in the Middle Eastern population. They stated that MMP7 lacks enough specificity and lower diagnostic accuracy compared to GGT in diagnosing BA from other causes of NC.…”

Section: Discussionmentioning

confidence: 99%

Pathologic approach to Neonatal cholestasis with a simple scoring system for biliary atresia

Ali,

Zalata,

Barakat

et al. 2023

Virchows Arch

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A liver biopsy is essential for the diagnostic workup of persistent neonatal cholestasis (NC). The differential diagnosis of NC is broad, including obstructive and non-obstructive causes. In addition, histologic features of certain disorders may be non-specific in the early course of the disease. To evaluate liver biopsies using a practical histopathologic approach for NC and to define a simple scoring system for biliary atresia (BA) for routine clinical practice. From June 2006 to December 2021, liver biopsy specimens from infants with persistent NC were examined by two independent pathologists. The cases diagnosed as BA were correlated with clinical, radiologic, and laboratory data to calculate the final score. Four hundred and fifty-nine cases were enrolled in the study. They had a mean age of 63.94 ± 20.62 days and were followed for a median time of 58 (1–191) months. They included 162 (35.3%) cases of BA. On multivariate analysis, portal edema, ductular proliferation, cholangiolitis, and bile duct/ductular plugs were the histopathologic predictors of BA. A liver biopsy did perform well with a 95.1% sensitivity, 91.6% specificity, 86% PPV, and 97.1% NPV. At a cutoff of 5 of the scoring system, diagnosis of BA could be done with a sensitivity of 95.1% and a specificity of 100%. We have shown detailed histopathologic features of BA with more depth to infants aged ≤ 6 weeks. We have developed a simple scoring system using a combination of liver biopsy with non-invasive methods to increase the diagnostic accuracy of BA.

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“…A study in Iran found the capability of the MMP-7 to distinguish BA from the non-BA cholestasis group fell significantly short of expectations. 39 We note that this study used a different ELISA kit compared to other studies. Besides, in this study, serum samples were stored at −20°C instead of −70°C or −80°C as in other studies, which may have led to protein degradation.…”

Section: Mmp-7mentioning

confidence: 96%

“…The results of some important clinical studies on MMP-7 from 2018 to 2023 are shown in Table 1. [31][32][33][34][35][36][37][38][39][40] According to the systematic review by He et al, 31 the sensitivity, specificity, and area under the curve of MMP-7 in the diagnosis of BA were 96%, 91%, and 0.9847, respectively. It is worth noting that the studies by Jiang et al 32 and Yang et al 33 were comparable, because they used the same enzyme-linked immunosorbent assay (ELISA) kit to detect serum MMP-7 concentration, both were conducted in China, and the median ages of the patients in the BA group were similar in the two studies.…”

Section: Mmp-7mentioning

confidence: 99%

Progress in Biomarkers Related to Biliary Atresia

Kong,

Dong,

Chen

et al. 2024

J Clin Transl Hepatol

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Biliary atresia (BA) is a congenital cholestatic disease that can seriously damage children’s liver function. It is one of the main reasons for liver transplantation in children. Early diagnosis of BA is crucial to the prognosis of patients, but there is still a lack of reliable non-invasive diagnostic methods. Additionally, as some children are in urgent need of liver transplantation, evaluating the stage of liver fibrosis and postoperative native liver survival in children with BA using a straightforward, efficient, and less traumatic method is a major focus of doctors. In recent years, an increasing number of BA-related biomarkers have been identified and have shown great potential in the following three aspects of clinical practice: diagnosis, evaluation of the stage of liver fibrosis, and prediction of native liver survival. This review focuses on the pathophysiological function and clinical application of three novel BA-related biomarkers, namely MMP-7, FGF-19, and M2BPGi. Furthermore, progress in well-known biomarkers of BA such as gamma-glutamyltransferase, circulating cytokines, and other potential biomarkers is discussed, aiming to provide a reference for clinical practice.

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Questioning Diagnostic Value of Serum Matrix Metalloproteinase 7 for Biliary Atresia

Cited by 8 publications

References 21 publications

Matrix Metalloproteinase-7 and Osteopontin Serum Levels as Biomarkers for Biliary Atresia

Matrix Metalloproteinase-7 and Osteopontin Serum Levels as Biomarkers for Biliary Atresia

Pathologic approach to Neonatal cholestasis with a simple scoring system for biliary atresia

Progress in Biomarkers Related to Biliary Atresia

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