{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T19:51:16Z","timestamp":1785873076384,"version":"3.56.0"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T00:00:00Z","timestamp":1650585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004156","name":"Mahidol University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004156","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Osteoarthritis and Musculoskeleton Research Unit, Faculty of Medicine, Ratchadapiseksompotch Fund, Chulalongkorn University","award":["CUGR63953002"],"award-info":[{"award-number":["CUGR63953002"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Inflammation and immune dysregulation persuade biliary duct injury in biliary atresia (BA), a leading cause of pediatric liver transplantation given lack of specific biomarkers. We aimed to determine associations between systemic cytokine profiles and clinical parameters in BA patients and to identify potential BA biomarkers.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Systemic levels of 27 cytokines were measured in 82 BA patients and 25 healthy controls using a multiplex immunoassay. Relative mRNA expressions of candidate cytokines in 20 BA livers and 5 non-BA livers were assessed using quantitative real-time PCR.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Higher levels of 17 cytokines including IL-1\u03b2, IL-6, IL-7, IL-8, IL-9, IL-2, IL-15, eotaxin, IP-10, MCP-1, MIP-1\u03b1, MIP-1\u03b2, G-CSF, IL-1ra, IL-4, IL-5, and IL-10 and lower levels of IFN-\u03b1 and PDGF were significantly associated with BA. In BA patients, increased levels of IL-7, eotaxin, IP-10, and IL-13 were significantly associated with unfavorable outcomes including jaundice, fibrosis, and portal hypertension. Indeed, systemic levels of those cytokines were significantly correlated with clinical parameters indicating jaundice, fibrosis, and hepatic dysfunction in BA patients. Out of 27 cytokines, 4 (IL-8, IP-10, MCP-1, and PDGF) had potential as sensitive and specific biomarkers of BA. Of these, higher IL-8 levels were significantly associated with reduced survival of BA. In BA livers, relative mRNA expressions of <jats:italic>IL-8<\/jats:italic>, <jats:italic>IP-10<\/jats:italic>, and <jats:italic>MCP-1<\/jats:italic> were significantly up-regulated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Higher levels of several cytokines including inflammatory cytokines, immunomodulatory cytokines, chemokines, and anti-inflammatory cytokines and lower levels of growth factors would reflect inflammatory and immune responses related to BA development. Among 27 cytokines, plasma IL-8 might have great potential as a diagnostic and prognostic biomarker for BA.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0267363","type":"journal-article","created":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T17:27:17Z","timestamp":1650648437000},"page":"e0267363","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":16,"title":["Systemic cytokine profiles in biliary atresia"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1132-7442","authenticated-orcid":true,"given":"Wanvisa","family":"Udomsinprasert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tachatra","family":"Ungsudechachai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paisarn","family":"Vejchapipat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Poovorawan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sittisak","family":"Honsawek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,4,22]]},"reference":[{"key":"pone.0267363.ref001","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1038\/nrgastro.2015.74","article-title":"(2015) Pathogenesis of biliary atresia: defining biology to understand clinical phenotypes","volume":"12","author":"A Asai","year":"2015","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"pone.0267363.ref002","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1097\/MOP.0000000000000214","article-title":"Recent advances in the pathogenesis and management of biliary atresia","volume":"27","author":"JA Zagory","year":"2015","journal-title":"Curr Opin Pediatr"},{"key":"pone.0267363.ref003","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1053\/j.sempedsurg.2012.05.003","article-title":"Biliary atresia: cellular dynamics and immune dysregulation","volume":"21","author":"AG Feldman","year":"2012","journal-title":"Semin Pediatr Surg"},{"key":"pone.0267363.ref004","doi-asserted-by":"crossref","first-page":"e81974","DOI":"10.1371\/journal.pone.0081974","article-title":"Profiles of serum cytokines in acute drug-induced liver injury and their prognostic significance","volume":"8","author":"NM Steuerwald","year":"2013","journal-title":"PLoS One"},{"key":"pone.0267363.ref005","doi-asserted-by":"crossref","first-page":"e2003","DOI":"10.1097\/MD.0000000000002003","article-title":"Selected cytokines serve as potential biomarkers for predicting liver inflammation and fibrosis in chronic hepatitis B patients with normal to mildly elevated aminotransferases","volume":"94","author":"YQ Deng","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"pone.0267363.ref006","doi-asserted-by":"crossref","first-page":"e0206389","DOI":"10.1371\/journal.pone.0206389","article-title":"Cytokine profiles in acute liver injury-Results from the US Drug-Induced Liver Injury Network (DILIN) and the Acute Liver Failure Study Group","volume":"13","author":"HL Bonkovsky","year":"2018","journal-title":"PLoS One"},{"key":"pone.0267363.ref007","doi-asserted-by":"crossref","first-page":"154497","DOI":"10.1016\/j.cyto.2018.07.028","article-title":"Type 3 cytokines in liver fibrosis and liver cancer","volume":"124","author":"MF Molina","year":"2019","journal-title":"Cytokine"},{"key":"pone.0267363.ref008","doi-asserted-by":"crossref","first-page":"19867","DOI":"10.1038\/s41598-020-76880-y","article-title":"Toll-like receptor 4 regulates intestinal fibrosis via cytokine expression and epithelial-mesenchymal transition.","volume":"10","author":"YK Jun","year":"2020","journal-title":"Sci Rep"},{"key":"pone.0267363.ref009","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1002\/hep.21701","article-title":"Serial circulating markers of inflammation in biliary atresia\u2014evolution of the post-operative inflammatory process","volume":"46","author":"B Narayanaswamy","year":"2007","journal-title":"Hepatology"},{"key":"pone.0267363.ref010","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1007\/s12519-015-0023-5","article-title":"The correlation between plasma cytokine levels in jaundice-free children with biliary atresia","volume":"11","author":"ZH Jian","year":"2015","journal-title":"World J Pediatr"},{"key":"pone.0267363.ref011","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1111\/liv.12001","article-title":"A high serum interleukin-12p40 level prior to Kasai surgery predict a favourable outcome in children with biliary atresia","volume":"32","author":"JF Wu","year":"2012","journal-title":"Liver Int"},{"key":"pone.0267363.ref012","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1055\/s-0036-1592136","article-title":"Systemic and local cytokine profile in biliary atresia","volume":"27","author":"T Saito","year":"2017","journal-title":"Eur J Pediatr Surg"},{"key":"pone.0267363.ref013","doi-asserted-by":"crossref","first-page":"8927","DOI":"10.3748\/wjg.v21.i29.8927","article-title":"Serum proinflammatory cytokines and nutritional status in pediatric chronic liver disease","volume":"21","author":"D Santetti","year":"2015","journal-title":"World J Gastroenterol"},{"key":"pone.0267363.ref014","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/j.1440-1746.2011.06962.x","article-title":"\u201cNormal\u201d liver stiffness values differ between men and women: a prospective study for healthy living liver and kidney donors in a native Korean population","volume":"27","author":"BK Kim","year":"2012","journal-title":"J Gastroenterol Hepatol"},{"key":"pone.0267363.ref015","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1002\/hep.23312","article-title":"Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease","volume":"51","author":"VW Wong","year":"2010","journal-title":"Hepatology"},{"key":"pone.0267363.ref016","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s00281-009-0154-7","article-title":"The immunobiology of primary sclerosing cholangitis","volume":"31","author":"JH Aron","year":"2009","journal-title":"Semin Immunopathol"},{"key":"pone.0267363.ref017","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1002\/hep.30051","article-title":"Cytokine-Producing B Cells Promote Immune-Mediated Bile Duct Injury in Murine Biliary Atresia","volume":"68","author":"J Bednarek","year":"2018","journal-title":"Hepatology"},{"key":"pone.0267363.ref018","doi-asserted-by":"crossref","first-page":"102ra94","DOI":"10.1126\/scitranslmed.3002069","article-title":"Dendritic cells regulate natural killer cell activation and epithelial injury in experimental biliary atresia","volume":"3","author":"V Saxena","year":"2011","journal-title":"Sci Transl Med"},{"key":"pone.0267363.ref019","first-page":"50","article-title":"Serum IL-6 and IL-8 in infants with biliary atresia in comparison to intrahepatic cholestasis","volume":"32","author":"AA El-Faramawy","year":"2011","journal-title":"Trop Gastroenterol"},{"key":"pone.0267363.ref020","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1016\/j.jpedsurg.2006.05.058","article-title":"The significance of serum hepatocyte growth factor levels in planning follow-up of postoperative jaundice-free patients with biliary atresia","volume":"41","author":"K Uchida","year":"2006","journal-title":"J Pediatr Surg"},{"key":"pone.0267363.ref021","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/S0022-3468(99)90197-5","article-title":"Serum IFN-inducible protein-10: a new clinical prognostic predictor of hepatocyte death in biliary atresia","volume":"34","author":"H Kobayashi","year":"1999","journal-title":"J Pediatr Surg"},{"key":"pone.0267363.ref022","doi-asserted-by":"crossref","first-page":"1967","DOI":"10.1016\/j.jpedsurg.2006.08.018","article-title":"The role of monocyte chemoattractant protein-1 in biliary atresia","volume":"41","author":"H Kobayashi","year":"2006","journal-title":"J Pediatr Surg"},{"key":"pone.0267363.ref023","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/j.jpedsurg.2021.03.038","article-title":"Granulocyte-colony stimulating factor GCSF mobilizes hematopoietic stem cells in Kasai patients with biliary atresia in a phase 1 study and improves short term outcome","volume":"56","author":"A Holterman","year":"2021","journal-title":"J Pediatr Surg"},{"key":"pone.0267363.ref024","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.3390\/jcm10091978","article-title":"Growth Factors Assessed during Kasai Procedure in Liver and Serum Are Not Predictive for the Postoperative Liver Deterioration in Infants with Biliary Atresia","volume":"10","author":"O Madadi-Sanjani","year":"2021","journal-title":"J Clin Med"},{"key":"pone.0267363.ref025","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/jhbp.297","article-title":"Hypoxic-ischemic gene expression profile in the isolated variant of biliary atresia","volume":"22","author":"LX Fratta","year":"2015","journal-title":"J Hepatobiliary Pancreat Sci"},{"issue":"120","key":"pone.0267363.ref026","first-page":"2357","article-title":"Association between serum platelet-derived growth factor BB and degree of liver damage, fibrosis and hepatitis B e antigen (HBeAg) status in CHB patients.","volume":"59","author":"XC Diang","year":"2012","journal-title":"Hepatogastroenterology"},{"key":"pone.0267363.ref027","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1002\/hep.21806","article-title":"Profibrogenic transforming growth factor-beta\/activin receptor-like kinase 5 signaling via connective tissue growth factor expression in hepatocytes","volume":"46","author":"HL Weng","year":"2007","journal-title":"Hepatology"},{"key":"pone.0267363.ref028","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1038\/labinvest.3700490","article-title":"Expression of toll-like receptors and type 1 interferon specific protein MxA in biliary atresia","volume":"87","author":"YH Huang","year":"2007","journal-title":"Lab Invest"},{"key":"pone.0267363.ref029","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1097\/00005176-200411000-00017","article-title":"Association of serum interleukin-8 levels with the degree of fibrosis in infants with chronic liver disease.","volume":"39","author":"V Nobili","year":"2004","journal-title":"J Pediatr Gastroenterol Nutr"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0267363","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T17:27:47Z","timestamp":1650648467000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0267363"}},"subtitle":[],"editor":[{"given":"Gianfranco D.","family":"Alpini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,4,22]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0267363","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,22]]}}}