We propose to remain a Member of the Childhood Liver Disease Research and Education Network (ChiLDReN). As a Charter Member of the Network, our proposal represents a logical extension of the long- standing commitment of our Center to improve the care of children with chronic liver disease through innovative patient-based research. In the previous member of the Network, we worked collaboratively with investigators from other Centers to build a strong infrastructure to conduct patient-based studies on biliary atresia, cholestatic syndromes, mitochondrial hepatopathies and cystic fibrosis. Our key contributions included data submission and analysis of two retrospective studies; leadership in the development, implementation, and completion of the first clinical trial (the steroid trial); high enrollment and retention of subjects into prospective studies; completion of ancillary studies seeking novel molecular phenotypes of biliary atresia; completion of a pilot project on defects in bile acid synthesis; and participation in working groups and committees related to project reviews, writing of manuscripts, and development of core resources. We look forward to significantly contributing to the operation of ChiLDREN through three aims.
In Aim 1, we will enroll subjects into prospective ChiLDREN protocols to enable translational science. This will be done by pursuing high enrollment rate of subjects into approved protocols, with the timely collection and submission of data and tissue samples to meet the enrollment goals established by the Network.
In Aim 2, we will develop and implement research protocols for clinical trials. We have worked with Network investigators and NIDDK Program Directors to start a new trial for infants with biliary atresia (PRIME trial), and are completing the regulatory requirements to start a trial investigating the efficacy and safety of a small molecule inhibitor of the intestinal sodium-dependent bile acid transporter (IMAGINE-ITCH-INDIGO trial). We are also working in research groups to develop a trial to test a new fat-soluble vitamin preparation to treat vitamin deficiencies in cholestatic children with biliary atresia (CholADEK trial) and the use of glycerol-phenylbutyrate to treat cholestatic children with progressive familial intrahepatic cholestasis (PFIC). And in Aim 3, we will use state-of-the-art molecular techniques in ancillary studies using ChiLDREN data and tissue to discover biomarkers of disease phenotypes and treatment in biliary atresia, and to define genetic mutations in children with mitochondrial hepatopathies. By pursuing the three aims, we will be well positioned to fully execute the new Network aims of pursuing clinical science projects and conducting trials to improve the outcome of children with liver diseases.

Public Health Relevance

We propose to become a member of the Childhood Liver Disease Research and Education Network (ChiLDREN) and to be a key contributor to the strong infrastructure to facilitate clinical sciences research and clinical trials in children with biliary atresia, cholestatic syndromes, mitochondrial hepatopathies, and cystic fibrosis. In addition, we will pursue ancillary studies to develop biomarkers of disease in biliary atresia and genetic basis of mitochondrial hepatopathies, and will seek to enroll subjects into innovative clinical trials to improve the outcome of children with liver diseases.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01DK062497-17
Application #
9514119
Study Section
Special Emphasis Panel (ZDK1)
Program Officer
Sherker, Averell H
Project Start
2002-09-15
Project End
2019-05-31
Budget Start
2018-06-01
Budget End
2019-05-31
Support Year
17
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Cincinnati Children's Hospital Medical Center
Department
Type
DUNS #
071284913
City
Cincinnati
State
OH
Country
United States
Zip Code
45229
Loomes, Kathleen M; Spino, Cathie; Goodrich, Nathan P et al. (2018) Bone Density in Children With Chronic Liver Disease Correlates With Growth and Cholestasis. Hepatology :
Ng, Vicky L; Sorensen, Lisa G; Alonso, Estella M et al. (2018) Neurodevelopmental Outcome of Young Children with Biliary Atresia and Native Liver: Results from the ChiLDReN Study. J Pediatr 196:139-147.e3
Alonso, Estella M; Ye, Wen; Hawthorne, Kieran et al. (2018) Impact of Steroid Therapy on Early Growth in Infants with Biliary Atresia: The Multicenter Steroids in Biliary Atresia Randomized Trial. J Pediatr 202:179-185.e4
Bezerra, Jorge A; Wells, Rebecca G; Mack, Cara L et al. (2018) BILIARY ATRESIA: Clinical and Research Challenges for the 21st Century. Hepatology :
Luo, Zhenhua; Jegga, Anil G; Bezerra, Jorge A (2017) Gene-disease associations identify a connectome with shared molecular pathways in human cholangiopathies. Hepatology :
Wang, Kasper S; Tiao, Greg; Bass, Lee M et al. (2017) Analysis of surgical interruption of the enterohepatic circulation as a treatment for pediatric cholestasis. Hepatology 65:1645-1654
Shneider, Benjamin L; Moore, Jeff; Kerkar, Nanda et al. (2017) Initial assessment of the infant with neonatal cholestasis-Is this biliary atresia? PLoS One 12:e0176275
Lertudomphonwanit, Chatmanee; Mourya, Reena; Fei, Lin et al. (2017) Large-scale proteomics identifies MMP-7 as a sentinel of epithelial injury and of biliary atresia. Sci Transl Med 9:
Shneider, Benjamin L; Magee, John C; Karpen, Saul J et al. (2016) Total Serum Bilirubin within 3 Months of Hepatoportoenterostomy Predicts Short-Term Outcomes in Biliary Atresia. J Pediatr 170:211-7.e1-2
Bezerra, Jorge A (2016) MDR3 mutation analysis: A step closer to precision medicine. Hepatology 63:1421-3

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