Serum matrix metalloproteinase-7 levels in infants with cholestasis and biliary atresia

Background The aim of this study was to evaluate the serum level of matrix metalloproteinase 7 (MMP7) in infants with cholestasis and the diagnostic values of this biomarker to differentiate biliary atresia (BA) from other causes of cholestasis. Methods This multi-center study is conducted during 2 years in Mofid children's hospital and Children's Medical Center, Pediatrics Center of Excellence Tehran, Iran. 54 infants with cholestasis were enrolled in this study with a control group consists of 41 healthy infants with the same age. Serum samples were taken from all these patients to assess serum levels of MMP7, Gamma-glutamyl Transferase (GGT). For each biomarker, we calculated the sensitivity and specificity and other statistical characteristics. Results There were 89 subjects, 22 patients with BA, 32 patients with non-BA cholestasis and 41 subjects as control group. The mean serum MMP7 levels in BA, non-BA cholestasis and control group was 15.91 ng/ml +/- 6.64, 4.73 ng/ml +/- 2.59 and 0.49 ng/ml +/- 0.33, respectively. The best cut-off point is calculated 7.8 ng/ml for MMP7 and 434.5 U/L for GGT. The area under curve (AUC) for these two markers are 0.988 +/- 0.008 and 0.854 +/- 0.052, respectively. The sensitivity and specificity of MMP7 to differentiate biliary atresia from nonbiliary atresia cholestasis in our study was 95.5% and 94.5%, respectively. The sensitivity and specificity of GGT was 77.3% and 77.8%, respectively. These results show that the MMP7 has more sensitivity and specificity in differentiation. Conclusion MMP7 demonstrated good accuracy to differentiate biliary atresia from other causes of cholestasis.

Automated summary

This study evaluated the serum level of matrix metalloproteinase 7 (MMP7) in infants with cholestasis and its diagnostic value in differentiating biliary atresia (BA) from other causes of cholestasis. The results showed that MMP7 had higher sensitivity and specificity compared to gamma-glutamyl transferase (GGT), making it a valuable biomarker for distinguishing BA from non-BA cholestasis.