Biliary Atresia Clinical Trial
Official title:
Dry Blood Spot Screening Test for Biliary Atresia and Other Cholestasis Diseases
Our study aims to develop a screening test for biliary atresia (BA) using dry blood spot to improve patient survival by early diagnosis. Newborn screening dry blood spot will be examined for the direct bilirubin (DB), γ-GT or matrix metalloproteinase-7 (MMP-7) levels. These findings will promote early diagnosis for BA and hence improve the survival.
BA accounts for approximately 60% of the liver transplantations in infants younger than 1
year of age. The diagnosis of BA remains a clinical challenge because affected neonates have
signs, symptoms, and serum liver biochemistry that are also seen in those with other causes
of neonatal cholestasis.
The success of the Kasai procedure is varied, but a good outcome is correlated with an early
diagnosis. Unfortunately, most BA are usually identified later and the average age at surgery
is about 60 days. To address this problem, some research groups screen infants for the pale
stools or measure bilirubin level in the serum. However, these screening programs have not
yet to be implemented because of several reasons. Recently, the relative abundance of serum
MMP-7 was suggested to have discriminatory features for infants with BA. Nevertheless,
whether the level of MMP-7 elevates in newborn dry blood spot of BA is still undefined. In
this study, we will explore a screening strategy based on DB, γ-GT or MMP-7 measurement in
newborn screening blood spot, and identify whether DB , γ-GT or MMP-7 measurement in the
newborn period could be sensitive and specific for BA.
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