Eur J Pediatr Surg 2010; 20(3): 164-168
DOI: 10.1055/s-0029-1243628
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Cyclooxygenase-2 Overexpression is Associated with Clinical Outcome in Biliary Atresia

S. Honsawek1 , N. Klaikeaw2 , P. Vejchapipat3 , V. Chongsrisawat4 , P. Ruangvejvorachai2 , Y. Poovorawan5
  • 1Faculty of Medicine, Chulalongkorn University, Biochemistry, Bangkok, Thailand
  • 2Faculty of Medicine, Chulalongkorn University, Pathology, Bangkok, Thailand
  • 3Faculty of Medicine, Chulalongkorn University, Department of Surgery, Bangkok, Thailand
  • 4Faculty of Medicine, Chulalongkorn University, Pediatrics, Bangkok, Thailand
  • 5Center of Excellence in Clinical Virology, Chulalongkorn University, Department of Pediatrics, Bangkok, Thailand
Further Information

Publication History

received July 14, 2009

accepted after revision October 29, 2009

Publication Date:
18 January 2010 (online)

Abstract

Objective: The purpose of this study was to investigate the association between cyclooxygenase-2 (COX-2) expression and clinical outcome in biliary atresia (BA) patients.

Methods: Six months after surgery, twenty-eight BA patients were divided into three groups according to their liver function tests: group A with satisfactory liver function (n=11), group B with moderate liver dysfunction (n=8), and group C with severe liver dysfunction (n=9). COX-2 expression was determined by immunohistochemistry. Choledochal cysts (n=5) and normal liver samples (n=4) served as controls.

Results: Our data have shown that the intrahepatic biliary epithelium in BA specimens expressed COX-2. The mean immunoreactive score of COX-2 in BA patients was significantly higher than that in choledochal cyst and normal liver (4.0±0.6, 0.9±0.3, and 0.7±0.3, respectively, p<0.002). Strong expression of COX-2 was observed in BA patients with severe liver dysfunction. Subgroup analysis showed that the mean COX-2 immunoreactive scores of patients in group A, B, and C were 2.1±0.6, 3.6±1.1, and 5.9±0.9, respectively. The COX-2 immunoreactive score in BA patients with severe liver dysfunction was higher than in patients with satisfactory liver function (p<0.005).

Conclusion: Increased COX-2 expression of biliary epithelial cells at the time of Kasai operation was associated with an adverse therapeutic outcome in BA, suggesting that COX-2 could play a plausible role in the liver pathology of BA.

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Correspondence

Dr. Sittisak Honsawek

Faculty of Medicine

Chulalongkorn University

Biochemistry

Department of Biochemistry

10330 Bangkok

Thailand

Phone: 662 2564482

Fax: 662 2564482

Email: Sittisak.H@chula.ac.th

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