Evidence map›Paper›PMID 39341941›Full record

ArticlePediatric research2025

Amyloid precursor protein as a fibrosis marker in infants with biliary atresia.

Jan C Kamp, Omid Madadi-Sanjani, Marie Uecker, Christopher Werlein, Lavinia Neubert, Joachim F Kübler, Mikal Obed, Norman Junge, Tobias Welte, Jannik Ruwisch and 4 more

Abstract read
In one paragraph

Article in Pediatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Jan C KampDepartment of Respiratory and Infectious Medicine, Hannover Medical School, Hannover, Germany. Kamp.Jan-Christopher@mh-hannover.de.ORCID 0000-0002-5002-409X
Omid Madadi-SanjaniCentre of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
Marie UeckerCentre of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
Christopher WerleinBiomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany.
Lavinia NeubertBiomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany.
Joachim F KüblerCentre of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
Mikal ObedCentre of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
Norman JungeDivision for Pediatric Gastroenterology and Hepatology, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
Tobias WelteDepartment of Respiratory and Infectious Medicine, Hannover Medical School, Hannover, Germany.
Jannik RuwischDepartment of Respiratory and Infectious Medicine, Hannover Medical School, Hannover, Germany.
Danny D JonigkBiomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany.
Jan StolkDepartment of Pulmonology, Leiden University Medical Center, Member of European Reference Network Lung, Section Alpha-1-Antitrypsin Deficiency, Leiden, The Netherlands.
Gertrud VietenCentre of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
Sabina JanciauskieneDepartment of Respiratory and Infectious Medicine, Hannover Medical School, Hannover, Germany.

Funding

Alpha One International RegistryDeutsche ForschungsgemeinschaftEuropean Research CouncilProjekt DEALStichting Marcel Brus Fonds
6 · The paper itself

Abstract

backgroundBiliary atresia (BA) is a rare condition of unknown origin in newborns with jaundice. In BA bile ducts are non-functional, causing neonatal cholestasis and following liver fibrosis and failure.

methodsThis retrospective study included liver biopsies of 14 infants with BA aged [mean ± SD] 63 ± 23 days. Patients were grouped according to the clinical course (jaundice-free vs recurrent jaundice vs required liver transplantation or liver fibrosis (Ishak fibrosis score)) and followed for 1.61-5.64 years (mean 4.03). Transcriptome profiles were assessed using a panel of 768 fibrosis-specific genes, reanalyzed via qRT-PCR, and confirmed via immunostaining. Plasma from an additional 30 BA infants and 10 age-matched controls were used for amyloid precursor protein (APP) quantification by ELISA.

resultsDifferent clinical outcome groups showed a homogeneous mRNA expression. Altered amyloid-metabolism-related gene expression was found between cases with Ishak fibrosis score greater than 4. Immunostaining confirmed a distinct presence of APP in the livers of all BA subjects. APP plasma levels were higher in BA than in age-matched controls and correlated with the histological fibrosis grade.

conclusionsThese results suggest that amyloidosis may contribute to BA and liver fibrosis, indicating that APP could serve as a potential liquid biomarker for these conditions. IMPACT: Biliary atresia patients with higher fibrosis scores according to Ishak have higher hepatic expression of amyloid-related genes while amyloid precursor protein accumulates in the liver and increases in the circulation. After a recent study revealed beta-amyloid deposition as a mechanism potentially involved in biliary atresia, we were able to correlate amyloid-metabolism-related transcript levels as well as amyloid precursor protein tissue and plasma levels with the degree of hepatic fibrosis. These findings suggest that amyloid precursor protein is a fibrosis marker in infants with biliary atresia, reinforcing the role of amyloid metabolism in the pathogenesis of this serious disease.

Indexed as

Amyloid beta-Protein PrecursorBiliary AtresiaLiver CirrhosisBiomarkersBiopsyCase-Control StudiesFemaleHumansInfantInfant, NewbornLiverMaleRetrospective StudiesRNA, MessengerAmyloid beta-Protein PrecursorAPP protein, humanBiomarkersRNA, Messenger

Identifiers

PMID39341941
PMCPMC12119347

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.